Chihuahua Rescue
Adoption Application

Return to Chihuahua Rescue

Instructions:
Tax Deductible Donation of $300 is Required for all Adoptions.
Note: We can only adopt to the greater Los Angeles metropolitan area. There are NO exceptions. For our purposes, San Diego is not considered part of this area. Applications from outside of this area are automatically rejected.
Contact Information:
Your Name:  
Address Line #1:  
Address Line #2:   (Optional)
City:  
State:   CA    
Zip:  
Home Phone:  
Work Phone:  
Cell Phone:  
Email:  
Contact Instructions:
What is the best way to get in touch with you?
Which Phone # and what time periods?		  
The Adoption:
Adoption Choices: If you want help finding the right dog, write "Would Like Assistance".
1st Choice:
2nd Choice:
3rd Choice:
Are you interested in
Adopting?
Fostering?
Why do you want to adopt a Chihuahua?
Family & Home:
Who shares your household?
Spouse
Significant Other
Relative
Roommate
Children
Live-in
I Live Alone
Type of dwelling?
House
Condo
Townhouse
Apartment
Trailer
Do you ...
Own?
Rent*?   If renting, are dogs allowed?
* A letter from your landlord or apartment manager will be required.
Your occupation?
Occupation of your Housemate?
Who is more the "dog person", you or your housemate?
Me
Housemate
If your present relationship were to change, with whom would the dog(s) remain?
At what age do you feel children are responsible enough to take care of a dog without assistance (i.e. walk, feed, etc)
Is anyone in your household allergic to dogs?
Yes
No
(Optional) Is there anything else you want to add regarding the questions in this section?
House:
Is someone home during the day?
Yes
No
How many hours will you leave the dog alone during the day?
(in whole hours)
What percentage of time will the dog be
% in the house?
% in the yard?
Which rooms, if any, are off limits to the dog(s)?
Is the dog allowed on the furniture?
Yes
No
Where will the dog sleep at night?
When you go to work, where will the dog be?
House
Yard
Doggie Daycare
Goes to work with me
Other
When you go on vacation, who will care for the dog?
Housesitter
Vet
Kennel
Friend's House
Friend feeds but does not stay
Other
Do you have a housekeeper who enters your home when you are not at home?
Yes    How long have you had this housekeeper?
No
Do you have a gardener?
Yes
No
Do you have a pool/spa?
Yes     Does it have a cover/fence?
No
Do you share your yard with other tenants?
Yes
No
Do you have a fenced yard?
Yes
No
Which of the following is used to secure your gate(s)?
Latch
Key Lock
Deadbolt
Other
During a 24hr period, when is your gate locked?
Days only
Nights only
Only when I leave the house
At all times
Other
I don't lock my gate because
I live in a safe neighborhood
My kids or other household members use it a lot
I and/or my housemate use it a lot
Meter readers must enter
I always lock my gate
Other
Do you have a doggie door?
Yes
No    Would you install one?
Have you ever lost a dog? (do not include death from illness or old age)
Yes*
No
*If Yes, what happened?
(Optional) Is there anything else you want to add regarding the questions in this section?
Food & Health:
Will you feed your dog...
canned?
dry food?
both?
What brand of food will you feed your dog?
Will you feed your dog "people food"?
Yes    If yes, what kind?
No
Who in your household will be mostly responsible for feeding the dog?
How many times per day, will you be feeding the dog?
Once
Twice
Three times
Free Feed
What do you think is a good way to keep your dog's teeth clean?
Never really thought about it
Do it myself
It's not necessary
Feed it dog biscuits
Have the vet do it
Other    
Which of the following will you use for flea control?
Flea sprays
Flea baths
Flea collars
Herbal flea collar
Carpet flea controllers
 Flea comb
Advantage
Frontline
Other    
(Optional) Is there anything else you want to add regarding the questions in this section?
Training & Disclipine:
What method will you use to housebreak your dog?
Have you ever trained a dog in obedience class?
Yes    If yes, what training methods did you use?
              Do you still use these training methods?
No
In which of the following situations, will you have your dog off leash?
Park
Dog Park
Small Dog Park
Hike
Beach
 Neighbor Walk
Front yard
Back yard
Will not be off leash
Other
What disclipine will you use if your dog chews your favorite shoes?
Which of the following disclipines will you use if your dog just won't listen and is really naughty?
Spank with hand
Spank fanny with newspaper
Swat nose
Stern voice
Other
When will your dog wear a choke chain?
Yes
No
Do you think it's necessary for your dog to wear an ID tag?
Yes   If yes, what kind? Vet/Rabies License With Phone # &/or Address.
No
(Optional) Is there anything else you want to add regarding the questions in this section?
The Important Stuff:
Under what circumstances, will you NOT keep your dog?
Divorce/Separation
Allergies
Dog barks a lot
Dog digs a lot
Dog nips at strangers
Dog bites kids
Dog loses control of bladder
Dog develops chronic illness
 Big vet bills
Dog is just untrainable
Dog is NOT the kind of dog I thought it would be
Having a baby
Move
Will always keep
Other
In the past, if you were forced to give up your dog, what did you do?
This is not a hypothetical question, please answer based on your past actual experiences.
Gave dog to a relative
Gave dog to a friend
Found home through newspaper
Gave to adoption group
Gave to animal shelter
Had vet put to sleep
Never needed to
I did what was necessary to keep my dog
Other
(Optional) Is there anything else you want to add regarding the questions in this section?
Vet Details:
Please give us your vet's contact information. If you don't currently have a vet, we'll be happy to recommend one.
Vet References are required for all applications. If you don't currently have a pet but had pets previously, Please give us the name & number of your previous vet even if you've moved.
Name:
Address:
City:
Phone Number:
Please note we will be calling your vet to check references.
When was the last time your pet was vaccinated or has been to the Vet?
(Optional) Is there anything else you want to add regarding the questions in this section?
Pet History:
Please describe your animal history below. Using one line per pet, please give us the name and breed (if not dog, just tell us what kind of animal) and the other requested information. Under "What Happened?", indicate whether or not you still have this pet or what happened, i.e. died, lost, stolen, etc. Use only one line per pet please.
Breed & Name Sterilized? Weight? How long owned? What happened?
1) lbs years
2) lbs years
3) lbs years
4) lbs years
5) lbs years
6) lbs years
7) lbs years
8) lbs years
9) lbs years
10) lbs years
(Optional) Is there anything else you want to add regarding the questions in this section?
Some Final Stuff:

PLEASE NOTE: WE REGRET THAT WE ARE UNABLE TO RESPOND TO ANY APPLICATIONS UNLESS ALL QUESTIONS ARE ANSWERED AND VETERINARIAN INFORMATION HAS BEEN PROVIDED.

Thank you for your interest in one of our dogs. Please be advised that filling out this application is not a guarantee of adoption.

Chihuahua Rescue is a Non-Profit Organization. Your donation is tax-deductible and will be put to good work for animals.

Moment of Action!

Here's what you've been waiting for. However, we earnestly recommend that you DOUBLE-CHECK your answers to be sure that you've answered ALL the questions. Being a highly active rescue organization, we can't spare the time to follow up on incomplete applications. Also applications can not be edited once they've been submitted.