Lhasa Apso Shih Tzu Rescue

Our adoption process is simple, but thorough. It is a 5-step process.

Application - Fill out the application and submit it to us via e-mail or e-mail.
A vet and personal reference check will be done.
A home visit will be scheduled with either the Director, Asst. Director, or an adoption counselor.
Contract - This is usually signed during the home visit.
Your new baby comes home to live!

Applicant's Full Name: Age:

Spouse's Full Name (if applicable): Age:

Physical Address: Street:

City: State: Zip:

Telephone Numbers
Home: Work:

Mobile: Other:

E-mail:

Children's Names & Ages (if applicable):

Other Adults in Your Home - Names & Ages (if applicable):

Your Occupation:

Employer's Name, Address, & Phone Number:

Number of Years Employed There:

Your Spouse's Occupation:

Your Spouse's Employer's Name, Address, & Phone Number:

Number of Years Employed There:

Nearest Relative Not Living in Your Household: Name:

Relationship: Phone Number:

How did you hear about our rescue organization?
Please specify:

Which Dog are you Interested In?

Have you ever owned a Lhasa Apso or Shih Tzu before? Yes No

Why are you interested in adopting a Lhasa Apso or Shih Tzu at this time?

If you rent, are pets permitted in your lease? Yes No

Are there any limitations in your lease as to type of pets, number, size, etc.? Yes No

If so, what are the limitations?

Landlord's Name, Address & Phone Number:

Is your yard fenced? Yes No

If yes, which best describes the type of fencing?
6 ft Wood Privacy Fence Chain Link Fence Wireless Fence
Other - Please describe

Do you have any of the following at your current residence? (Check all that apply)
Pool (fenced) Pool(no fence) Doggie Door Problem Neighbors
Legal Restrictions Regarding Pets (please describe)

Do you or any member of your household have allergies, especially to pets? Yes No

Who is, or would be, responsible for your pets while you go on vacation, or should a situation arise that would cause you to be absent from home for a few days?

How many hours a day would this pet be alone?

Where would it be during the day while you are at home?

Where would you leave it while you are away from home?

Where would it sleep at night?

Where would it get excercise? How Often?

As it is not uncommon that rescue dogs frequently need housebreaking or at the very least, a refresher course,
are you prepared to deal with this problem? Yes No

How would you deal with this problem should it arise?

Pet History

List all animals that you currently own or have owned in the past five years that are in or have been in your care and give the following information on each:
Name, Species (dog, cat, etc.), Breed, Age (now or at death), How Long Owned, Where is it now,
Still owned?, Deceased?, Housed (inside/outside/both), Sex, Spayed/Neutered. If deceased, give complete details and circumstances

Pet #1	Pet #2	Pet #3	Pet #4

Pet #5	Pet #6	Pet #7	Pet #8

Have you ever surrendered or released an animal to a shelter or rescue group?
Yes No If yes, please explain:

Are you currently or have you ever been suspended by the AKC or any national breed organization for any reason?
Yes No If yes, please explain:

Have you ever been convicted of animal abuse, neglect or cruelty?
Yes No If yes, please explain:

Have you ever been denied adoption for any reason by a shelter, humane society, or other rescue group?
Yes No If yes, please explain:

Veterinarian & Personal References

Primary Vet
Name: Phone Number: Address:

Previous/Other Vet (if used within the past two years)
Name: Phone Number: Address:

Additional References (Please give three. They can be relatives, friends, or co-workers)

Reference #1 Name: Relationship:
Phone Number: Best Time to Call:
Address:

Reference #2 Name: Relationship:
Phone Number: Best Time to Call:
Address:

Reference #3 Name: Relationship:
Phone Number: Best Time to Call:
Address:

Do you understand that references and a home visit WILL be done? Yes No

I/We understand that approval of such application is solely at the discretion of LASTR, and that any false information given or omissions in this application or during the required home visit is immediate cause for rejection.

I/We also give permission to have an agent come into my/our home at a time and date agreed upon in advance for the purpose of establishing that the home, in his/her opinion, would be a suitable environment in which to place an adopted animal. I/We understand LASTR under no obligation to give me/us an explanation should my/our application not be approved.

We will notify you via e-mail or phone (if no e-mail) upon receipt of your application. If you have not heard from us within 10 days of mailing, please e-mail us to confirm receipt.

Available Dogs Lhasa Apso Shih Tzu Rescue
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