Lone Star Shih Tzu and Lhasa Apso Rescue Adoption and Foster Application

This questionnaire is designed to help you think through the various aspects of dog ownership that should be considered before you adopt a dog.  Please answer ALL questions and elaborate as much as possible.  Your answers give us a better idea of what you might consider the right dog for you.   Again, PLEASE take the time to respond to EACH and EVERY question.  If you have not read through our ADOPTION PROCEDURES, please do so before completing the application. Please use the TAB key to move from field to field. DO NOT hit the ENTER KEY until you have completed all the information.  If you accidentally hit the enter key and submit an unfinished application, simply hit the "back" button on your browser.  You should return to the partially completed form.

APPLICANT INFORMATION

First Name:

Last Name:

Street Address:

City, State, Zip

Home Phone:

Cell Phone:

Home Email:

Birthdate: (Note - you must be at least 21 to apply to adopt one of our dogs.

Employer:

Street Address:

Blitz, Snap, Cupid, Ginger, Nena and Chach These beautiful little girls were all rescued by a member of Lone Star Shih Tzu and Lhasa Apso Rescue and have all been adopted.

City, State, Zip

Work Phone:

Work Email:

Please include a valid email address.  All of our volunteers work full-time jobs and are often unable to make phone calls.  We will be able to communicate much more frequently and completely with you via email.

Occupation:

Are you applying to:

Adopt Foster Adopt and Foster

OTHER SUCCESS STORIES

CO-APPLICANT INFORMATION

First Name:

Last Name:

Relationship to applicant

Spouse Significant Other Parent Sibling Son/Daughter Roommate

Cell Phone:

Home Email:

Birthdate: (Note - you must be at least 21 to apply to adopt one of our dogs.

Employer:

Street Address:

City, State, Zip

Work Phone:

Work Email:

Occupation:

Please tell us about the people that live with you and the people that visit you frequently.

Name

Age

Relationship to you

Frequency of visits

Lives here full time Visits weekly Visits monthly Rarely visits

Lives here full time Visits weekly Visits monthly Rarely visits

Lives here full time Visits weekly Visits monthly Rarely visits

Lives here full time Visits weekly Visits monthly Rarely visits

Lives here full time Visits weekly Visits monthly Rarely visits

Lives here full time Visits weekly Visits monthly Rarely visits

Are there smokers in your household?  We ask this because some of the dogs have such serious eye problems, they should not be in a smoking household.

There are smokers in this household. We do smoke, but only outside. No one smokes in this house.

Which of the following best describes your current residence?

Own a single family home Own a townhome or condominium Rent/lease a single family home Rent/lease an apartment Own a mobile home Live with relative

How is your yard secured?

No Fencing Wood Privacy Fence - 6' high Chain Link Fence Wrought Iron Fence

If you do not have a securely-fenced yard, how will you ENSURE that your dog does not escape?

Do you have a doggie door?

Yes No

Yes, I have a pool - it is not fenced, though. Yes, I have a pool - with a security fence around it. No Pool

Do you have a pool?

If you do not have a securely-fenced pool,  how will you ENSURE that your dog does not fall into the pool and drown?

If you rent, please give the name and phone number of your landlord.

Please tell us about your current pets:

I have not owned a pet in my adult life I've had pets, but no dogs I've had dogs as an adult, but never a small breed I've had small dogs for less than a year I've had small breed dogs for 1-3 years, but not shih tzu or lhasas I've had small breed dogs for more than 3 years, but not shih tzu or lhasas I've had shih tzu or lhasas for 1-3 years I've had shih tzu or lhasas for more than 3 years

How long have you had him/her?

Age when you got him/her

Where did you get him/her?

Where is he kept when you are not home?

Breed

Name

Species

Sex

Dog Cat

Female - Intact Female - Spayed Male - Intact Male - Neutered

Loose outdoors in a secure fenced yard In a dog run Loose in the garage Loose in the basement Loose indoors Crated in the bedroom Gated in the kitchen In the laundry room or bathroom

Dog Cat

Female - Intact Female - Spayed Male - Intact Male - Neutered

Loose outdoors in a secure fenced yard In a dog run Loose in the garage Loose in the basement Loose indoors Crated in the bedroom Gated in the kitchen In the laundry room or bathroom

Dog Cat

Female - Intact Female - Spayed Male - Intact Male - Neutered

Loose outdoors in a secure fenced yard In a dog run Loose in the garage Loose in the basement Loose indoors Crated in the bedroom Gated in the kitchen In the laundry room or bathroom

Pet's age when you got him/her

How long did you have him/her?

Please tell us about your past pets:

What happened to him/her?  Be specific.

Breed

Name

Species

Sex

Dog Cat

Female - Intact Female - Spayed Male - Intact Male - Neutered

Dog Cat

Female - Intact Female - Spayed Male - Intact Male - Neutered

Dog Cat

Female - Intact Female - Spayed Male - Intact Male - Neutered

If you have never had a small dog before, we may ask that you attend a two-hour seminar on the health and care of lhasas and shih tzu.  Are you willing to attend this seminar?

No, I just want a dog. Yes, the seminar sounds like a great idea! No, I've had small dogs before and understand the health issues No, I've had snippy dogs before and understand how to handle them

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

Please list any personality traits which you would to see in your new dog - lap dog vs. hyper, love sponge vs. independent, etc.

Where will this dog spend time when you are not at home?

How many  hours during a normal day will the dog be left alone?

More than 12 6-12 hours 3-6 hours 3 hours or less

Loose outdoors in a secure fenced yard In a dog run Loose in the garage Loose in the basement Loose indoors Crated in the bedroom Gated in the kitchen In the laundry room or bathroom

Where will the dog sleep?

Who will care for your dog when you are out of town?

Please give the name, address and phone number of your veterinarian.   This should be a veterinarian that you have worked with in the past.   Also, if the records are not in the exact name listed above, please list the exact name on the account at your vet. We must have this reference to process your application.  And, please be sure your vet is expecting our call.  Once we received the faxed records from you, we'll call your vet to clarify any questions we have.  If you have no vet, please type "NO VET" in the vet's name field.

Vet's name

Address

Phone number

Pets taken to this vet

What years?

Name on the account.

Please give the name, address and phone number of your current groomer or a groomer you used in the past with your previous pets.  If you've never used a groomer, please type "NO GROOMER" in the field

Please give us three references with dogs that we can contact for information about how you interact with small dogs.    These should be people you know well that can tell us why you would be a perfect owner.  Geting the reference checks done is the single most time consuming endeavor and has delayed an application by two, three, even four, weeks.  PLEASE alert your friends that we will be calling and ask them to call us back quickly.  We would prefer only one family reference.

What type of dog(s) do they have?

How long have you known this person?

Daytime Phone Number

Evening Phone Number

Name

Email

More than 12 hours 8-12 hours 5-8 hours 3-5 hours Under 3 hours

On a normal day, how long will the dog be left home without an adult  human?

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

Why do you want a dog?  Please elaborate.

No dogs really come already housebroken.  They may be trained to my routine, but not yours.   How will you housebreak your dog?

Although we do not take people-aggressive dogs into our program, we do accept abused and un-socialized dogs.  These dogs often need work with temperament problems.  How will you deal with behavior problems like snapping or biting?  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 to your environment differently and you must be prepared to deal with it.

Do you understand that dogs 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 this can you give me more information? I do understand that dogs bite out of fear and I will protect my dog from all obnoxious strangers that enter my home.

Do you understand that 75% of the dog bite cases involve dogs that have NEVER bitten anyone before and that you, as the owner/guardian of that dog shoud take whatever measures are necessary to avoid putting your dog in a situation where he/she might become afraid and snap?

I do not understand this and want a dog that will NEVER bite. I do understand that even though a dog has never bitten anyone before, there is a good chance that he/she will if provoked. I want a dog that will NEVER bite, even out of fear.

What will you do if your dog bites your child or a friend's child?

We ask that you take your dog to an obedience class (8 weeks) within two months of adopting the dog.  The classes we recommend are designed to teach you how to deal with the dog.  Are you willing to adhere to this requirement?  If no, why not?

No. Yes, I'm anxious to learn how to communicate with my new dog. I've taken obedience classes before and will train him/her myself

For the dog's safety and your sanity, we also ask you to obtain a crate and crate train your dog.   Are you willing to adhere to do this?  If no, why not?

No, I'm not willing to crate train my dog. Yes, I'm anxious to learn how to crate train my dog.

Do you understand that it may cost as much as $1200 a year for grooming, routine veterinary visits, high-quality food and supplements and non-routine veterinary visits.

Wow, I had no idea - I cannot afford this! My dog is well worth $1200 a year - I probably will spend more than that on toys.

Our adoption process is fairly involved and approval to adopt from us often takes several weeks.  How long are you willing to wait for us to match the perfect little dog to your lifestyle?

How ever long it takes Six weeks One month

One thing you can do to help speed up the approval process is to have your vet fax to us your vet records.   Even if your dog is no longer with us, the history recorded in the vet records provides us quite a bit of insight into the type of dog that might do well in your home.  Fax them to 281-754-4851.

I have no vet reference I'll have them faxed over immediately

Shih Tzu and Lhasa Apsos can live to be 17, 18 even 20 years old.  Adopting a dog is a life-long commitment much like that to a child.  These dogs are totally dependent on you for their lives - they are not disposable possessions - so please consider this  when you are applying to adopt one of our dogs.  Think carefully about how you will react in the circumstances described.

Picture yourself in 15 years.  Imagine what your life style will be like.  Now, with that picture in mind, consider that you will be caring for an older, deaf, blind and possibly incontinent dog.  Explain why you think you can make the commitment to care for this little dog with the same love and devotion that he/she has give you for the last 15 years?

What would happen to your dog if something happened to you within the next 15 years and you could no longer care for him/her?  Who would take the dog?  Please provide the following information.

Address:

Name:

City, State, Zip

What type of pet do they have now?

Home Phone:

Cell Phone:

Home Email:

Vet's name:

Vet's Phone:

How does this person feel about taking responsibility for a dog that may be 14-15 years old at the time?

It's often VERY costly to care for an elderly dog.  Have you made a provision in your will for the ongoing care of this dog?

What would happen if you had to move and couldn't find a place that accepted your dog?  What would you do with him/her?

What would happen if your dog got very sick and you were looking at spending thousands of dollars to cure the illness?  How much would you be willing to spend to keep your dog healthy?

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 includes  spay/neuter, DHLPPC immunization, Rabies immunization, Bordetella immunization, general health examination, dental procedure, tumor removal, heartworm treatment (if necessary), etc.  The ONLY way we can continue to save dogs like Cherie, Hunter, Dallas, Ace, etc from certain euthanasia is with the donations you make to reimburse Shih Tzu Rescue for these veterinary procedures.  We request a minimum donation of between $250 to $350 which covers the basic health exam, neuter/spay and immunizations.   This amount varies by dog. Our goal is to NEVER say no to a shih tzu or lhasa apso in danger of euthanasia - the only way we can do it is with your donations.  We DO NOT reduce the adoption fee - although we know it is high, understand that you are not only adopting the dog, you are helping the other ones in need  You are the kind of generous, good-hearted people we want our dog to spend the rest of their lives with.  So, thank you for helping us help them.

Please acknowledge that you understand the adoption donation.

No response. Application will not be processed. I would like to donate more than $350 to help save other little lives. I understand that the adoption fee is between $250 and $350. I'm not paying that. I expect someone else to foot the bill for my dog.

Our volunteers all work full time jobs and we usually only have a couple of hours a week to process applications.  Consequently, we aren't as prompt at processing the applications as we wish we were.  If you don't hear from one of us in a few days, email us.  And keep emailing - we love to carry on a good dialog about the dogs via email.  It tells us a lot about you.

Is there anything else you would like us to consider when processing your application?

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 are your responsibility now.  Having a little dog is like having a totally dependent, yet loving and obedient, toddler at your side for the rest of your life.  ARE YOU UP TO THIS?  Please think about this long and hard.  This is a life long commitment.

Comments?  Concerns?  Please give us your feedback.

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 complete 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.

Today's date

Signature of adoption  applicant

Please look over ALL of the answers 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. Lone Star Shih Tzu and Lhasa Apso Rescue of Texas