Adoption Application Form

(Note: All fields marked with an * are required. If you do not fill in a required field, you will be given an error message prompting you to complete the required fields.)

Personal Information

Enter whole numbers only
Enter whole numbers only
Best phone number to contact you


Current Pets

Dog, cat, bird, etc.
Enter whole numbers only
Dog, cat, bird, etc.
Enter whole numbers only
Enter whole numbers only
If you have more than three pets please provide similar information about all of your additional pets.

Past pet information

give information below
If you have had more than two pets in the past please provide similar information about all of your additional pets.

Knowledge about brachycephalic dog:

Living arrangements

If yes, how soon?
A "No" answer will NOT disqualify you.

Questions about ownership & the adoption process

(What kind of things do you plan to do to make your new pug feel like it\s part of the family?)
(relieving itself indoors, barking too much, chewing, demanding a lot of attention)
Check all that apply
(for work or other commitments)
Check all that apply

Please provide information about the regular Vet/Clinic you use or plan to use

If known
By checking this box you are authorizing your Vet and their office to answer any and all questions we may have about any current or past pets seen by their office.

It is vital to us that you know where your local emergency animal clinic is located. Pleae take the time to find out before submitting this application. Call your vet for information if you are having problems locating a 24 hr emergency clinic in your area.


Is there anything else you'd like us to consider that we failed to ask? (You can clarify other answers here as well.) This is your chance to shine.

Neither Philly Pug & Short Nose Rescue, Inc. (PPSNR), nor its volunteers, coordinators, representatives, Internet Service Provider and its officers, employees, contractors and representatives; and any other person, firm or corporation involved with the efforts or business of this corporation, shall be held liable or responsible for any claims or causes of action incurred as a result of the provision or restriction of information, services, contacts, adoptions, fostering, veterinary care or by the actions of any and all dogs transferred or referenced herein.

Moreover, there is absolutely no guarantee made or implied that any person requesting to adopt a dog being fostered through PPSNR, or posted on PPSNR’s Website, will be allowed to adopt a PPSNR dog. Rather, all adoption applications are subject to acceptance based on a review process that may require collecting information from references and visiting the applicant’s home. All decisions on placing dogs in adoptive and foster homes are based solely on the judgment of the volunteers and coordinators of PPSNR and adoption applications submitted through this form are often denied for various reasons. PPSNR reserves the right to make all decisions regarding placement or final disposition of any rescued dog in its care whether in, or being placed in, a foster or adoptive home or other facilities.

All information gather in the review process is the property of PPSNR and will be keep confidential.

Please be prepared to correspond with the adoption team via email. Due to restrictions on application volume, time, and the general nature of rescue, almost all of our correspondences are done by email. Please check your email regularly to see if you have been contacted.

Please note that adoption applications will only be accepted from persons 21 years old or older.

Finally, in rescue, we deal with the unknown and usually we do not have full medical histories on our rescues. PPSNR discloses any and all information known about its rescues prior to every adoption. In addition, all rescues are spayed or neutered, current on shots and heartworm negative prior to placement. They are all also treated for all known medical conditions while in foster care. Medical conditions and behavioral issues may arise after a placement and because there is no way to predict these issues, PPSNR will not be held responsible for any costs incurred after the adoption. By clicking the link below and completing an application, you acknowledge that you understand all of the above terms and conditions on this page.

By pressing the “Submit” button on the application, you attest that you have read the above disclaimer and agree to the terms therein.