Chihuahua-Toy Breed Rescue and Retirement - We've rescued over 150 abandoned and abused dogs

Adoption Application

Chihuahua-Toy Breed Rescue
P.O. BOX 245906
Pembroke Pines, FL 33024

We need to know as much about you as possible. Each question you answer on this application will help us better serve you and a rescued Chihuahua. Please be honest with your answers on the following questions. The information is to help us determine the best possible match for you as well as for a rescued Chihuahua. There are no right or wrong answers and you will not be disqualified because of any answer you give. Also, your cooperation in answering all of these questions will help speed the process. Thank you!

(Chihuahua-Toy Breed Rescue & Retirement, Inc reserves the right to refuse any application to adopt for any reason.)

If all required fields are not filled. The application will be discarded.

Fields with a * are required.

* Name
* Age
* Driver's Lic. #
* Marital Status
Spouses Name
Spouses Age
* Address Line 1
Address Line 2
* City
* State
* Zip
* Home Phone #
Cell/Beeper
* Best Time To Call:
* What is the best way to contact you?
* Employer:
* Job Title:
Work Phone #:
* WorkingHours:
*Email Address
* Where did you hear of us?	CRAR.ORG PETFINDER.COM FLYER Other
* Why are you looking to adopt a dog, and why did you choose to adopt rather than buy from a pet store or breeder?
* What dog(s)/cat(s) are you interested in adopting?
* Is this a gift for someone?	Yes No
* What made you decide to adopt this particular pet over the others?
* What do you think the average temperment of the breed you've selected to adopt is?
* Please relate any prior experience you have had with this breed:
* Type of Home:	Single Family Home Apartment/Condo Town Home MobileHome Town Home
* Do you rent or lease your home?	Yes No
Does your landlord allow pets?	Yes No Don't Know
Landlord's Name
Landlord's Telephone
* How many adults live at home?

* How many children live at home?
What are the children's ages?
* Please describe an average weekday in your household (please include work/school arrival/departure times):
* Your newly adopted pet's living situation (check all that apply):	Dog will live indoors (except for potty) Dog will live indoors & outdoors Dog will live in garage/basement Dog will live outdoors only Dog will live outdoors only with a dog house/shade
* When home alone, your newly adopted pet would stay where? (check all that apply):	Loose indoors Confined to one room Kept crated indoors Kept crated outdoors Outside loose in fenced area Outside loose in unfenced area Tied/Chained outdoors
* How will you exercise your dog? (check all that apply):	Leash walks daily In outdoor kennel/run Free run of fenced yard Free run of unfenced yard
* What do you consider to be resonable ROUTINE Veterinary expenses for your new pet YEARLY?	Under $50 Under $100 Under $200 Under $300 Under $400 $400+ I have no idea, but would be willing to spend whatever is necessary to keep my new friend happy and healthy
* What will you do if your new pet becomes destructive?
* Under what circumstances would you consider finding somewhere else for your pet to live?
* What would you do if you could not keep a dog?
* What behaviors would you consider unacceptable?
* What would you do to correct the above behavior (check all that apply):	Go to dog training classes Contact a private trainer Give dog away to someone else Contact Chihuahua-Toy Breed Rescue

*Do you currently have any pets? Yes No

Please list any pets you have now, or have had in the past 10 years?

Name of Pet
Type of Pet
Breed
Sex
How long with you?
What happened to the pet?	Gave Away Ran Away Stolen Hit By Car Died (explain)

Name of Pet
Type of Pet
Breed
Sex
How long with you?
What happened to the pet?	Gave Away Ran Away Stolen Hit By Car Died (explain)

Name of Pet
Type of Pet
Breed
Sex
How long with you?
What happened to the pet?	Gave Away Ran Away Stolen Hit By Car Died (explain)

Name of Pet
Type of Pet
Breed
Sex
How long with you?
What happened to the pet?	Gave Away Ran Away Stolen Hit By Car Died (explain)

Name of Pet
Type of Pet
Breed
Sex
How long with you?
What happened to the pet?	Gave Away Ran Away Stolen Hit By Car Died (explain)

If additional space is needed please continue in the comments section (at the end of the application).

Please list the veterinarian that you've used in the past (if applicable).If you've used more than one vet, throughout your pet-owning years please list additional Vets below as well. If you've never had a pet please list the vet that you plan to use on your newly adopted pet.

PRIMARY:


Veterinarian's Name
Hospital Name
Hospital Address
City
State
Zip
Telephone

SECONDARY:


Veterinarian's Name
Hospital Name
Hospital Address
City
State
Zip
Telephone

Did you use a Heartworm Preventative on your past pets? (if applicable)	Yes No N/A
Do you use a Heartworm Preventative on your current pets? (if applicable)	Yes No N/A
If yes, what brand?
If yes, where did you purchase it?
* Are/Were your current pets vaccinations kept up to date? (select most applicable answer)
* What age dog would you consider adopting?
* Would you consider adopting an abused dog?	Yes No
* Would you consider adopting a special needs dog?	Yes No
* What temperament do you like your pets to have?
Additional Comments:
* I agree to return the adopted animal to Chihuahua-Toy Breed Rescue if I can no longer care for it	Yes No
* I'm financially/physically able to care for the adopted animal. I understand the expenses involved in pet care and I'm able & will meet these requirements.	Yes No
* I'm stating that the information in the above pages is true, as typed, and that if any information is found to be false CTBRR will reclaim the said animal	Yes No
* I understand that should I adopt from CTBRR, the adoption donation goes toward the cost of caring for all of the rescue dogs. And can be between $150-350 average being $150-250. This is determinded by the medical costs of the dog you wish to adopt.	Yes No
* I have indicated that this is a valid and legal substitution for your written signature on this legal document.	Yes No
If all required fields are not filled. The application will be discarded.

How You Can Help

We never refuse even the neediest of dogs. Because of this we are in desperate need of donations. 100% of your donation goes directly to feeding, housing, and medical costs. You can also help with supplies (crates, leashes, collars, bowls, food, frontline/advantage, HEARTGUARD, etc). If you would like to donate in any way at all please call us at 954-989-9766. Remember all donations are tax-deductible.

Thank You!