First Name*
Last Name*
Address
City
State/Province
Zip/Postal Code -
County
Email*
Home Phone
Work Phone x
Cell Phone
Alt Email
You are completing this application to be a co-applicant for one our potential adopters at their request. Our goal is to always find the last home that each of our dog's need. Our adoption contract stipulates that if an adopter can no longer care for the dog, the dog must be returned to the rescue. We will always take our dogs back. However, we understand that transferring the dog back into rescue can be traumatic for the dog and if we have a pre-approved adopter, most likely already known to the dog, that maybe a better alternative. WE DO REQUIRE THAT CO-APPLICANTS HAVE A VERIFIABLE VETERINARY HISTORY OF DOG OWNERSHIP EITHER WITH A CURRENT DOG OR A DOG WITHIN THE LAST 5 YEARS. You are completing this application to be considered as the co-applicant so that in the event that applicant adopts one of our dogs and can no longer care for the dog, the dog would then be legally transferred to you under our adoption contract. PLEASE COMPLETE THIS APPLICATION AS IF YOU WERE BEING CONSIDERED FOR ADOPTION. This application should contain only your information as we will be processing it in conjunction with the primary applicant. THIS APPLICATION WORKS BEST WITH A CHROME BROWSER. Please do not use a tablet or telephone to fill out this application. Please initial that you have read this and understand in the box below. *
Applicant Age* Choose one: 18-20 21-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94
What is the name of the primary applicant for whom you are submitting this Co-Applicant Application?*
How many people currently live in the home? Please include the names and ages of everyone living in the home (for any minors, names are not required but we do require their ages). *
If you were referred to our rescue, met a volunteer or met us at a recent event, please list their name or the event attended.
How did you hear about us*
Are you interested in a specific dog? Choose an animal: Chancey - OS Hezly - PMD Liz - OS Marnie - Fairfield Olivia- PMRT Rocky - OS
Is there a second dog that you would be interested in if your first choice was no longer available? Choose an animal: Chancey - OS Hezly - PMD Liz - OS Marnie - Fairfield Olivia- PMRT Rocky - OS
Do you have a preference for a male, female or best fit?
Would you be interested in a pair of dogs* Choose one: Yes No Possibly
Do you have an active application with another rescue* Choose one: Yes No
What is the name of the other rescue?
Are you willing to travel to Central Ohio to pick up your new family member? (We do not ship our dogs. You must be willing to travel to Central Ohio to finalize the adoption or your application will not be processed.)
Are you willing to accept a dog with special medical needs such as eye drops, a special diet, or a daily medication?
Are you willing to adopt a dog with a history of neglect or abuse who may need extra love and attention and may take additional time to adjust to your household or is especially fearful of new situations?
Would you consider a mixed breed such as a Shih Tzu-Poodle; Cockapoo; Maltipoo; Shorkie; Morkie, etc?
How long are you willing to wait to adopt your new family member? (Our application process usually takes several weeks so if you indicate a shorter time we may be unable to process your application. A lot depends on how readily we are able to contact your references and the number of applications currently being processed.)*
Have you previously owned a Shih Tzu or similar dog that required regular grooming?
What do you like about the breed you are applying to adopt?*
Have you considered adopting other breeds and why?*
Virtually all of the dogs we have are considered high maintenance because of the grooming requirements. Why are you interested in adopting one of our dogs?*
Taking your family situation into consideration, what would you consider to be the top 3 - 5 characteristics of your new dog?*
Are you prepared to pay someone up to $40, or more, every 4 to 6 weeks to groom your dog? Or are you prepared to purchase a grooming table, clippers, scissors and other accessories and devote the time to learn to groom your high maintenance dog yourself? * Choose one: I am willing to pay for grooming Will purchase supplies to groom dog myself
Are you or anyone in the household a smoker? (Some of our dogs have sensitivities to smoke so they would not be a good fit in a smoking household. *
Do you (the applicant) own or rent your home? (We do verify property ownership which means that the property must be in your name.) If you do not own the property, we must be able to contact the property owner for their approval.* Choose one: Rent Own
If you rent, have you received the approval of your landlord to have an animal Choose one: Yes No
If you rent, please enter your landlord's name and phone number
In what type of home do you live* Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing
Do you currently have your yard, or a portion of your yard, securely enclosed with a physical fence?* Choose one: Yes No
What type of fence do you currently have at your home or use with your current dog? NOTE: PLEASE READ OVER OUR FENCING REQUIREMENTS UNDER THE ADOPTION INFO TAB ON OUR WEBSITE. Choose one: Chain Link Invisible Other Privacy Split Rail Wrought Iron
Please describe the height and other pertinent details of your fence and if your fence has direct access from a door to your house?
If you do not have access to a fenced area, please explain how you plan to exercise your dog and allow it to relieve itself?
Do you currently have a doggie door in use?* Choose one: Yes No
If you answered yes to having a doggie door, please describe its use? Choose one: Open 24/7 Open when home Open when not home Other
How much time will the animal spend alone during the day*
Will the animal be kept inside or outside* Choose one: Inside Only Outside Only Inside and Outside
Where will the animal be kept when you are not home*
Where will the animal be kept when you are home*
Where will the animal sleep*
Who in the household will care for the pet*
Do you travel frequently? If yes, who will care for the dog while you are away?*
Have you asked yourself whether your lifestyle is so busy you might not have the time or energy to properly care for a high maintenance dog? *
Does everyone in the family want a new dog? *
In the event that you could not care for the dog for a lengthy period of time or even permanently, how would you handle or prepare for this situation?*
Does anyone in the household have any known allergies to animals?*
If you adopted a dog and, at some point in the future, it developed a correctable, but costly medical issue (i.e., over $1,000), how would you handle this situation? *
What will you do if your spouse, children or pets can't get along with the dog?*
What is your definition of correcting a dog's unwanted behaviors?*
CURRENT PETS: What animals currently live in the household? (Please list type of animal, NAME, sex, altered or not, age and how long you have owned them, and are they inside or outside animals) NOTE: If you list any pets in this section, please be sure to include their NAME and the veterinarian that provides their care. If you do not provide this information, your application will be delayed. *
PRIOR PETS: If you have had animals in the past 10 years that are no longer living or living in your home, please list type of animal, NAME, sex, altered or not, age and how long you owned them, were they inside or outside animals, and why do you no longer own? NOTE: If you list any pets in this section, please be sure to include their NAME and the veterinarian that provided their care. If you do not provide this information, your application will be delayed. *
Have you ever given up a pet? If yes, please explain*
List three personal references, FIRST AND LAST NAME (who are not family members or listed as a reference in another portion of this application) with their contact information - either telephone numbers, email addresses or both. WE DO REQUIRE 3 PERSONAL REFERENCES AND THEIR CONTACT INFORMATION IN THIS SECTION OR WE CANNOT PROCESS YOUR APPLICATION.*
Veterinarian's Name and Phone Number. Please specify if this veterinarian has you listed as a client or if this is the vet you intend to use. NOTE: PLEASE BE SURE TO CONTACT YOUR VETERINARIAN AS SOON AS YOUR APPLICATION IS SUBMITTED TO GIVE THEM PERMISSION TO SPEAK WITH ONE OF OUR VOLUNTEERS, IF YOU DO NOT GIVE PERMISSION YOUR APPLICATION WILL NOT BE PROCESSED.*
If you have a groomer that you have used in the past, please include their name and number.*
If your application is approved to adopt one of our dogs, our adoption contract is a lifetime contract. In the event that you cannot care for the dog you adopt, you are required to contact the rescue to return the dog.* Choose one: I understand and acknowledge
We do not place our dogs on a first come, first served basis. We are looking for the best possible home for each and every one of our foster dogs. We are looking for the last home our foster dogs will need. We regularly receive multiple applications on our foster dogs. I understand that by submitting an application, I am not guaranteed a dog. * Choose one: I understand and acknowledge
I certify that the information entered on this applicant is true. Enter your name and date
I understand that I am not applying to adopt a dog at this time. I am applying to be approved as a co-applicant for the above named applicant. I understand that my application will be processed in conjunction with the above applicant and that I must meet the same adoption requirements as an applicant or specific requirements for the dog that the applicant applied for. In the event that the above applicant is not approved, or does not adopt, this application will be closed.* Choose one: Yes No