Adoption Procedure - 4 Step Checklist
	Printable Adoption Application
	Are Adoption Fees Too High?
					Step 1 - Adoption Application Form
Please fill out EVERY BLANK. Your application can't be processed if you leave blanks.
How Did You Hear about Us? Choose Answer Web Search Newspaper Petco or PetsMart Petfinder Other Important instructions for using drop down selection boxes: Once you click on the down arrow and select your answer, move your mouse outside of the drop down box and click your mouse in a clear area to de-select the drop down box.  If you don't do this and you use the scroll wheel on your mouse, you could change your selected answer without realizing it If Other, Please Specify I am applying to Adopt Foster Adopt and Foster Applicant Information Last Name First Name Street Address   City, State, Zip   Home Phone Cell Phone   Email Address   Birthdate (mm/dd/yy)                 Employer   Employer Address   Employer Phone       Occupation   Work Phone Work Email   Co-Applicant Information Last Name First Name   Relationship to Applicant Choose One Spouse Significant Other Partner Parent Sibling Son/Daughter Roommate   Home Phone Cell Phone   Email Address   Birthdate (mm/dd/yy)                 Employer   Employer Address   Employer Phone       Occupation   Work Phone Work Email   About You and Your Home Although we will adopt to great families anywhere in the continental United States, we normally DO NOT ship our dogs.  We believe you must meet your new family member BEFORE we finalize the adoption.  Therefore, we ask that you come to the Texas city in which your potential family member is being fostered in order to meet us and your new dog.  This happens after the entire application approval process. N/A - I live in Texas I do not want to go out of my way to get a dog I understand and will make arrangements to pick up my dog I would like to discuss the possibility of shipping my dog         Please tell us about the people that live with you or the people that visit you frequently.  Please include your children, nieces and nephews, grandchildren, neighboors, etc. Name Age Relationship to You Frequency of Visits Lives here full time Visits weekly Visits monthly Less than monthly Lives here full time Visits weekly Visits monthly Less than monthly Lives here full time Visits weekly Visits monthly Less than monthly Lives here full time Visits weekly Visits monthly Less than monthly Lives here full time Visits weekly Visits monthly Less than monthly Are there smokers in your household? Allergies prevent some of our dogs from being in homes with smokers. Choose Answer There are smokers in the house. We smoke but not in the house. No smokers Which best describes your current residence? Choose Answer I own a single family home. I own a townhome or condo. I rent/lease a single family home. I rent/lease an apartment I live in a mobil home I live with relatives How is your yard fenced? If you don't have a securely fenced yard, how will you ENSURE the safety of your dog? Do you have a dog door? No Yes Do you have a pool? No Yes If you have a pool, how will you keep a dog safe? If you rent, please give us the name and phone number of your landlord. Please Tell Us About Your Current Pets Name Species/Breed Sex/Altered Year Adopted Age Now Where did you get them When you are not at home where does your pet stay? F-Not spayed F-Spayed M-Not neutered M-Neutered Outside in a fenced yard Outside in a dog run Securely tied in the yard On an enclosed porch In the garage Gated in a bathroom Gated in a utility room Crated inside Loose inside F-Not spayed F-Spayed M-Not neutered M-Neutered Outside in a fenced yard Outside in a dog run Securely tied in the yard On an enclosed porch In the garage Gated in a bathroom Gated in a utility room Crated inside Loose inside F-Not spayed F-Spayed M-Not neutered M-Neutered Outside in a fenced yard Outside in a dog run Securely tied in the yard On an enclosed porch In the garage Gated in a bathroom Gated in a utility room Crated inside Loose inside F-Not spayed F-Spayed M-Not neutered M-Neutered Outside in a fenced yard Outside in a dog run Securely tied in the yard On an enclosed porch In the garage Gated in a bathroom Gated in a utility room Crated inside Loose inside F-Not spayed F-Spayed M-Not neutered M-Neutered Outside in a fenced yard Outside in a dog run Securely tied in the yard On an enclosed porch In the garage Gated in a bathroom Gated in a utility room Crated inside Loose inside Please Tell Us About Your Past Pets Name Species/Breed Sex/Altered Year Adopted What happened to them? Please be specific. F-Not spayed F-Spayed M-Not neutered M-Neutered F-Not spayed F-Spayed M-Not neutered M-Neutered F-Not spayed F-Spayed M-Not neutered M-Neutered F-Not spayed F-Spayed M-Not neutered M-Neutered F-Not spayed F-Spayed M-Not neutered M-Neutered Please Tell Us About The Dog(s) You Want To Adopt List the dogs by name that your are interested in. List any personality traits you would like to see in your new dog. (lap dog, playful, quiet). How many hours in a normal day will the dog be left alone?. 0-3 3-6 6-9 9-12 More than 12 Where will the dog stay when you are not at home? Choose Answer Outside in a secure fenced yard Outside in a dog run Securely tied in the yard On an enclosed porch In the garage Gated in a bathroom Gated in a utility room Crated inside Loose inside Where will the dog sleep? Who will take care of the dog when you are out of town? Why do you believe that you will be able to provide an excellent home for this dog? Why do you want a dog ?  Please elaborate Your References Please give us the name and contact information of your current vet.  Please let them know that we will be contacting them. If you have no vet, write NO VET in "Name" box.     Vet's Name Clinic Name Address Phone Number Pets they have seen How many years have you used this vet? Name on the account Fax number     Please give us the name and phone number of your groomer.  If you don't use a groomer, write "No Groomer". Groomer's Name Groomer's Phone Number     Please give us the names of three references who have dogs that we can contact for information about how you interact with your pets.  Only one family member please. This part of the application is sometimes the most time consuming.  Please let your references know that we may be contacting them. Name Email Day Phone Evening Phone Years Known What type of pets do they have? Miscellaneous Information Although the majority of our dogs are crate trained or trained to the routine and schedule of their foster homes, most dogs will need to be re-house trained to your home and your routine.   How do you plan to house train your new dog?   Although we do not take people aggressive dogs into our program, we do accept abused and unsocialized dogs.  These dogs often need work with behavior problems.   Any dog that has ANY known history of snapping will not be adopted to a family with children.  But understand that a dog may react differently and you must be prepared to deal with it.  How will you deal with behavior problems like snapping or biting?   Do you understand that dogs can bite out of fear and distrust?  Unfortunately, they do not have hands to slap the face of that obnoxious stranger that is grabbing and touching them.  The only way they have to protect themselves is with their teeth. I didn't know that. Can you give me more information? I understand and will protect the dog from strangers.   Do you understand that 75% of dog bite cases involve dogs who have never bitten anyone before and that you, as the dog owner, should take whatever measures are necessary to avoid putting your dog in a situation where he might become afraid and snap. I do not understand this and I want a dog that will never bite. I understand this and will protect my dog from these situations.   What will you do if your dog bites your child or a friend's child? We may ask that you take your dog to an obedience class within two months of adopting the dog.  Please state whether you are or are not willing to take this dog to an obedience class.  If you are not, tell us why not. Are you willing to crate train your dog? Choose Answer No, I am not going to crate train. Yes, I am willing to crate train my new dog. Considering grooming and normal veterinary care, it may cost $1,200 annually to care for your dog.  Are you aware of this? Choose Answer No, I do not intend to spend that much on a dog Yes, I will probably spend much more than that Shih Tzus and Lhasa Apsos can easily live 17 or 18 years. Who will take care of your dog if something should happen to you and you can no longer take care of him?  Please give us their name, address, phone number and email address. Have you ever given up a dog? Choose Answer Yes No If Yes, please explain and give date. Who has the dog now? Please give us their contact information? Under what circumstances would you feel that you would HAVE to give up your dog? Is there anything else that you would like for us to consider when processing your application? Adoption Donations When we bring dogs into our program, we have our vet perform the procedures that you, as a responsible pet owner , would have done after you adopt.  This would include spay/neuter, DHLPPC immunization, Rabies immunization, Bordetella immunization, general health examination, dental procedures, etc.  The ONLY way we can continue to save dogs from certain euthanasia is with the donations you and others make to reimburse Lone Star Shih Tzu and Lhasa Apso Rescue for these veterinary procedures.   When adopting, we request a minimum donation which helps us recover the cost of the basic veterinary procedures.  The range of this basic donation is between $150 to $600 and is based on the age of the dog you are adopting. We also perform more expensive procedures as needed such as heart worm treatment, tumor removal and other necessary surgeries, etc.  However, the minimum donation is still calculated according to the age of the dog being adopted.  Please see our Frequently Asked Questions (FAQ) page for more details and the donation amounts.  Click here to open the FAQ page in a new browser window. Our goal is to never say no to a Tzu or Lhasa in danger of euthanasia.  The only way we can do this is with your donation.  Your donation helps replace what we spent on your dog and gives us the funds to rescue another.  If you can donate more than the adoption donation for your dog, we would really appreciate it. Please acknowledge that you understand the adoption donation policy. No response, Application will not be processed. I understand that the adoption donation is between $150 and $600 I would like to donate more than the $600.00 adoption donation. I am not willing to pay an adoption donation that high. Statement of Truth Please type the following paragraph in the box below. Substitute your name (s) in the space indicated By submission of this application, I/We [insert name here] assert that all statements and answers given in said application are the said truth.  Any misrepresentation of the truth in this application will invalidate any subsequent adoption agreement and will give Lone Star Shih Tzu and Lhasa Apso Rescue of Texas the right to reclaim the adopted dog without refund of the adoption fee. Electronic Signature (Type your name) Date Before you click the submit button, please look over ALL of the answer you gave on this application. If you left critical information out we cannot process the application and we will ask you to fill it out again. We know this is time consuming but we are only trying to find the perfect home for each little dog. You are almost done!  Here's a quick reminder of the process... Step 1:  Submit this form. Step 2:  Ask your veterinarian to fax your records. Step 3:  Ask your 3 references to submit the reference questionnaire. Step 4:  The home visit. For instructions on steps 2, 3 and 4, click here to open the 4 Step Checklist and instructions in a new browser window.   Or you can submit this form and then go back to www.shihtzu-rescue.com and click on "Apply To Adopt" to go directly to the 4 Step Checklist and instructions. Finally, please remember that we are an all volunteer organization.  Our volunteers have full time jobs and families.  All that we do with this organization is done in our spare time so we ask that you be patient.   Although we make every effort to process each application in a timely fashion, sometimes there are delays due to the availability of our volunteers.  If you don't hear from us within a week or so, please do e-mail us.  We love to hear from you by e-mail and are happy to answer any questions you have as the process goes along. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Once you press the "Submit" button, a screen will appear showing you the detailed answers you gave.  This form is automatically emailed to one of our volunteers.  You may also print out the form and mail it or fax it to us at: Lone Star Shih Tzu and Lhasa Apso Rescue PO Box 1346 Pinehurst,TX 77362-1346 Fax 281-754-4851
		POLICIES AND OTHER INFORMATION Most of the dogs we get in come from shelters.  Therefore, we rarely get in a dog that we would feel comfortable placing in a home with small children.  Most of our dogs require a home with children no younger than ten. We do not adopt to families with children under ten years of age unless there is already an adult (older than six years old) lhasa or shih tzu in the family and we can securely determine that the children in the household have been taught to respect pets. We are not looking to "get rid" of our dogs.  We are looking for the BEST possible home for each and every one of them.  Therefore,   we do reserve the right to refuse to adopt a dog to any family for any reason. OUT OF STATE ADOPTIONS We do adopt to certain people out of state.  We ask that you come to Texas to meet and pick up your dog.  We believe you, too, want to be certain that this is the dog for you, so we ask that you arrange to stay a day or so getting to know your new family member before you travel back home.  Only under certain circumstances will we ship a dog and, of course, it will be at the adopter's expense.  The typical shipping fee is $350. If you decide that you can't keep the dog,  you are responsible for getting him or her back  to us as well.   If you live in another area of the country, but could not find a dog in your area, check our NATIONAL Shih Tzu Rescue website, www.usshihtzurescue.com.   You can fill out an application there and the national coordinator will forward your application to the representative nearest you. OTHER CONSIDERATIONS We do not adopt to households with un-spayed or un-neutered pets unless the pet is being shown for conformation or there is a verifiable medical reason that it is not altered. The average life span for a shih tzu can easily be 15-16 years.  We try to match the life span of the dog to a family.  Understand that we do not want these little guys to be homeless again in just a few years.   Adopting a new family member should involve a well-thought out and deliberate process.  We purposely take our time in finding just the right home for our dogs.  This is not an impulse "purchase."   We ask for lots of information, including reference statements from at least three good friends/relatives and your veterinarian.  If you are not willing to gather this information to help us make a decision, please do not apply with us.   We designed the application to be very thorough and our process for approving an applicant is just as stringent.   If you are applying to adopt a very young dog (under three years of age), in most cases, we will require that you have another dog of a similar age.  Shih Tzu and Lhasa Apsos like companionship and need a friend with which to play.