Yankee Pug Dog Club Rescue Application

Yankee Pug Dog Club Rescue Application
Mail completed application to:
Chair Person: Michael Farina, 8 Landing Road, Higganum, CT 06441
Phone: 860-345-4808 | Email: [email protected]
Date: ___________________________
Your Name: First _____________________ Last _____________________
Spouse Name: First _____________
Address: Number/Street ________________________________________
City/State: ______________________ Zip: _________________
Phone: (
) _________ - _____________
E-mail address: ___________________________________________
Pug Preference: Age _____ o male o female o fawn o black
Information - Please check the ones that apply:
1. Do you live in a o house o condo o apartment?
2. Do you have a fenced in yard? o yes o no / If yes, is it o full o partial?
3. Is your street o busy o quiet?
4. Owned dogs before? o yes o no
5. Children in household ? o yes o no age(s) _______
6. Other Pets? o yes o no Type/age ________________ / If cats, are they de-clawed? o yes o no
7. Is your veterinarian familiar with flat faced breeds? o yes o no
8. Are you interested in receiving YPDC newsletter? o yes o 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.