ALAC Adoption Application

Please specify which Lhasa Apso(s) on our website you might be interested in adopting, and the State they are in. Put N/A if no preference. *
Your Full Name [First & Last] *

Your full name please
Email *

Your email please
Full Address, Street, City, State & Zip *

Put Your Full Mailing Address [Street, City, State, Zip Code]
Home, Work & Cell Phone in that order *

Home, Work & Cell Phone in that order
Your Occupation & years you have worked there *

Your Occupation & years you have worked there
Hours Worked *

Hours Worked
Employers Name & Phone number *

Employers Name & Phone number
If less than 2 years employed, previous job *

If less than 2 years employed, previous job
Applying to Lhasa Rescue Network for *

Applying to Lhasa Rescue Network for
If you chose D in the previous question, please specify what you are able and willing to do to help rescue.
I have special abilities that I believe can be of help to Rescue. They are:

If you chose D in the previous question, please specify what you are able and willing to do to help rescue.
I have special abilities that I believe can be of help to Rescue. They are:
I am applying for Fostering, and I understand that I must also submit the Contract and Liability Release to help with Foster Care. *

I am applying for Fostering, and I understand that I must also submit the Contract and Liability Release to help with Foster Care.
Landlord's Name, Phone & Address *

Landlord's Name, Phone & Address
Which of the following best describes your current residence? *

Which of the following best describes your current residence?
If you rent, are pets permitted in your lease? Indicate weight if applicable:

If you rent, are pets permitted in your lease? Indicate weight if applicable:
How is your yard secured (is it fenced ect...)? If it is fenced what kind of fence do you have? *

How is your yard secured (is it fenced ect...)? If it is fenced what kind of fence do you have?
Do you have a Pool? *

Do you have a Pool? 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?
Do you have a doggy door? *

Do you have a doggy door? Yes No

Do you have a doggy door?
How many adults in your home including you?
Please List All Of Them *

How many adults in your home including you?
Please List All Of Them
Please list the children living with you (by ages) *

Please list the children living with you (by ages)
If you do not have children now, are you considering starting a family in the future?

If you do not have children now, are you considering starting a family in the future
Your Age, Your Spouses Age? *
Do you plan on moving in the next 6 months? *

Do you plan on moving in the next 6 months? Yes No

Do you plan on moving in the next 6 months?
Would the dog go with you? *

Would the dog go with you? Yes No
Please list all current & previous pets in this format:
1. Name, 2. What kind of pet, 3. Sex, 4. Spayed or neutered, 5. Age
6. Where is it housed (inside, outside, both), 7. Where is it now? If it is deceased please explain what happened. Please be as detailed and truthful as possible.
If you have never had a pet just put N/A. *
Please list any specific characteristics that you want to see in your new dog - lap dog vs. hyper, love sponge vs. independent, etc... *

Please list any specific characteristics that you want to see in your new dog - lap dog vs. hyper, love sponge vs. independent, etc...
Who will be responsible for this Lhasa? *

Who will be responsible for this Lhasa?
How many hours a day will this Lhasa be alone? Where will it be kept at night?

How many hours a day will this Lhasa be alone? Where will it be kept at night?
Where will the dog stay during the day? *

Where will the dog stay during the day?
Is anyone in the household allergic? *

Is anyone in the household allergic? Yes No

Is anyone in the household allergic?
Would you adopt a special needs dog/puppy? (ie. blind, timid, 3 legged, daily medication)? *

Would you adopt a special needs dog/puppy? (ie. blind, timid, 3 legged, daily medication)? Yes No

Would you adopt a special needs dog/puppy? (ie. blind, timid, 3 legged, daily medication)?
Why are you interested in getting a Lhasa at this time? *

Why are you interested in getting a Lhasa at this time?
All of these dogs need a refresher course in housebreaking. How will you housebreak your dog? *

All of these dogs need a refresher course in housebreaking. 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. *

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. *

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.
What would happen if your dog got very sick and you were looking at spending thousands of dollars to cure the illness? *

What would happen if your dog got very sick and you were looking at spending thousands of dollars to cure the illness?
Do you plan to walk your Lhasa Apso at least 2 times per day? *

Do you plan to walk your Lhasa Apso at least 2 times per day? Yes No

Do you plan to walk your Lhasa Apso at least 2 times per day?
Do you have a disability that would keep you from walking your Lhasa? *

Do you have a disability that would keep you from walking your Lhasa? Yes No

Do you have a disability that would keep you from walking your Lhasa?
Have you ever given up a pet in the past? If so please explain why. *

Have you ever given up a pet in the past? If so please explain why.
What would make you consider giving up your Lhasa: (check all that apply) *

What would make you consider giving up your Lhasa: (check all that apply) Accidents in the house Problems with another pet Moving Divorce New baby (afraid dog might bite) Aggression toward anyone Other, please specify below

What would make you consider giving up your Lhasa: (check all that apply)
Other reasons I would consider giving up my Lhasa are

Other reasons I would consider giving up my Lhasa are
What would happen to this Lhasa if family situation changed (divorce, relocation, death)?
Please answer this question in detail. *

What would happen to this Lhasa if family situation changed (divorce, relocation, death)?
Please answer this question in detail.
Have you ever given away/sold or released an animal to a shelter or rescue group? If yes, why? *

Have you ever given away/sold or released an animal to a shelter or rescue group? If yes, why?
Have you ever been denied adoption by a shelter or other rescue or humane group? If yes, by whom? *

Have you ever been denied adoption by a shelter or other rescue or humane group? If yes, by whom?
Vet's Name, Phone & Address (we need all 3, apps not giving all will be discarded), if you don't have one please explain. *

Vet's Name, Phone & Address (we need all 3, apps not giving all will be discarded), if you don't have one please explain.
Please give three references. These may be friends, co-workers and relatives.
Please give their name
Relationship to you
Email address
Phone number *

Please give three references. These may be friends, co-workers and relatives.
Please give their name
Relationship to you
Email address
Phone number
Any additional comments or information you would like to include.
Your Signature & Date, by signing, this signifies you agree this is a legal and binding contract between ALAC Rescue & You. *

Your Signature & Date, this signifies you agree this is a legal and binding contract between ALAC Rescue & You.
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