Colorado Shih Tzu Maltese and Lhasa Apso Rescue

First Name:

Last Name:

Home Phone:

E-mail address:

Contact Preference:

Address Line 1:

City & State:

ZIP/Postal Code:

Date of Birth xx/xx/xxxx and Place of Birth:

Occupation and Work phone:

How long have you lived at the above address:
Name and Phone number of landlord if applicable:

Adoption Application Question: Tell us about the people that live with you and the people that visit you frequently.
Name(s):,Age(s):,Relationship to you:

Question: Has anyone in your immediate family/household ever been convicted of a charge related to child abuse or cruelty to animals?

No Yes

Question: In relation to animal cruelty charges is there any such charge(s) pending?

No Yes

Question: If yes to any of the above, please explain and give disposition of charge(s).

Question: List the dog(s) by name (currently available from the website), that you might like to adopt. We will try to help you determine which dog will fit into your lifestyle best.

Question: Please list your preference regarding sex of dog:

Male Female Not important to me.

Question: Why do you want a dog? Please elaborate.

Question: Why do you believe that you will be able to provide an excellent home for this dog?

Question: Why do you want the breed that you have chosen?

Household Information

Please give us names and contact information of two references with dogs that we can contact for information about how you interact with animals. Please list people you know well that can tell us why you would be a perfect owner.

Current Pet(s) in your household.

Question:Please tell us about your current pets.
Name(s);Species;Breed(s);Sex(es);Neutered/Spayed;Age(s) when and where you got him/her?

Question: No dogs really come already housebroken. They may be trained to the foster’s routine, but not yours. How will you housebreak your dog?

Question:
What are the requirements for dog owners in your community (i.e., number of pets you may legally have, rabies vaccination, etc.)

Question: What circumstances, in your mind, justify getting rid of a dog?

Question: Please tell us about your past pets.

Name; Species; Breed: Sex; How long did you have him/her?

What happened to your pet?

Question: Have you ever sold, given away and/or surrendered a pet(s) of yours? If yes, why?

Please take a moment to carefully read the following before submitting your application.

A Life Long Commitment: Please add any comments about this application in the box below.

Picture the face of the sweet little dog you would like to adopt. Picture him sitting at your feet looking up at you with adoring eyes. Picture him noticing that you are looking and now he gets up and comes over to kiss your hand and ask for a pat on the head. Do you feel the total love and adoration these little dogs can give? Understand that many of them have never been treated well, never known a kind pat on the head or a loving word from a human. They've only known suffering, pain, and neglect. Understand that once you adopt them, you ARE their life and if YOU don't do right by them, they will go to their death never knowing love.   Keep them safe, love them no matter what. Be patient, teach them right from wrong. They will be your responsibility. These little dogs thrive on tender loving care and will be a happy, fun, and loyal companion to you for the rest of your life.

ARE YOU UP TO THIS? Please think about this long and hard. This is a life long commitment.

If you are approved, a copy of this form must be signed by applicant and co-applicant (if applicable) prior to the adoption being finalized.

I/WE HEREBY SWEAR THAT ALL OF THE INFORMATION PROVIDED ABOVE IS TRUE AND ACCURATE TO THE BEST OF MY/OUR KNOWLEDGE. SHOULD A DOG BE PLACED WITH ME/US, IT WILL RESIDE IN MY/OUR HOME AS A PET. I/WE AGREE TO PROVIDE THE DOG WITH ADEQUATE FOOD, WATER, SHELTER, LOVE AND AFFECTION, TRAINING, IDENTIFICATION, AND MEDICAL CARE. I ALSO UNDERSTAND AND AGREE THAT THE DOG WILL NEVER BE GIVEN TO A SHELTER, BUT IF FOR SOME UNFORESEEN REASON I/WE NEED TO FIND A DIFFERENT HOME FOR THE RESCUE DOG, I/WE WILL CONTACT THE RESCUE ORGANIZATION AND PLACE THE RESCUE DOG WITH SAME, SO THAT A SUITABLE HOME MAY BE FOUND FOR HIM OR HER.

Thank you for taking the time to complete this application. By submitting this application you attest to the truthfulness of your answers.   Falsification of any of the above information will be grounds to disallow your adoption of a rescued dog.

Submit Your Adoption Application by Clicking "Submit" Below:

Thank you for your application!

Once you click the submit button, your application will go blank and a message will appear above where you typed you first name that says, "Thank you for your message." This lets you know that your application has be sent and a member of our rescue will contact you soon. In a few days, if you do not receive an acknowledgment that we have your application, please contact the director, Nancy Beims at 303-289-2541

ShihTzuCo@aol.com

Colorado Shih Tzu Maltese and Lhasa Apso Rescue

Adoption Application

Need More Information?

To adopt one of our rescue dogs, please fill out the ONLINE application form below. Please keep in mind the following: