Yankee Pug Dog Club Rescue Application
First _____________________ Last ____________________________
Name: First ________________Last______________________
Address: Number/Street ______________________________________________
City/State: ______________________ Zip: _________________
Phone: ( ) _________ - ________
E-mail address: ________________________________________________________
Pug Preference: Age _____ male____ female____ fawn____ black____
Information - Please check the ones that apply:
1. Do you live in a ___house ___condo ____apartment?
2. Do you have a fenced in yard? yes___ no___ / If yes, is it ___full _____partial?
3. Is your street ____busy ____quiet?
4. Owned dogs before? ____yes ____no
5. Children in household ? ____yes ____no age(s) _______
6. Other Pets? ____yes ____no Type/age ________________
If cats, are they de-clawed? ____yes ____no
7. Is your veterinarian familiar with flat faced breeds? ____yes ____no
8. Are you interested in receiving YPDC newsletter? ____yes ____no
9. Are you interested in becoming a YPDC Member? ____yes ____no
Personal References (please supply two):
1. Name/Address/Phone ___________________________________________________________________________
2. Name/Address/Phone ___________________________________________________________________________
Yankee Pug Dog Club Policy There is a non-refundable adoption fee of $225.00 per Pug adopted to help defray veterinary costs, payable upon receipt of the Pug. Prior to placement, all Pugs are completely Vet checked, made up to date on all shots and spayed or neutered. The YPDC maintains a file of applicants. As rescue Pugs become available, they are matched to a suitable person or family. This is not done on a first-come first-served basis. YPDC does follow up on placements to assure a successful transition. YPDC retains first right of refusal if placement does not work out. The Pug must be returned to YPDC for further placement. YPDC places approximately six Pugs per year.
How did you hear of Yankee Pug Dog Club? ________________________________________________________________________________
Please notify YPDC if you have adopted a Pug or another breed elsewhere, or wish to be removed from our waiting list.