ADOPTION APPLICATION

We strive to make the adoption process as simple and timely as possible. We do, however, want to make sure that our dogs are adopted into a home where they will spend the rest of their lives being loved and cared for.

Please note: if you have unaltered dogs (not spayed or neutered), an invisible fence or smoke in your home, we will be unable to place a dog with you.

To adopt one of our dogs, you will need to complete the Adoption Application form below, including references. If our foster home determines your home may be a good fit for the dog, they will call your references, and if all is well, they will then schedule a home visit with you. We ask that all family members be present during the visit. Then we require a 24 hour thinking period, and if all are in agreement, the dog will then go to his/her forever home. During this process, we will do our best to keep you apprised of the progress.

All Questions Must Be Answered Below or you may receive an error upon submitting. Red boxes will highlight the questions you may have missed during the process. If a question does not apply to you or your living situation, please answer N/A.

Is there a specific NorthStar dog that you are interested in adopting? (please answer N/A if there is not a specific dog you are interested in and answer the next question.)

If there isn't a specific dog you are interested in adopting, please describe the type of dog you would like. Include age, gender and personality.

About You

First Name

Last Name

Street Address

City

State

Zip

Email

Email Confirmation

Your Phone

Preferred Method of Contact
EmailPhone

The best time to reach me is

About Your Residence & Family

Having a dog is a commitment that will require extra time from you including caring for and working with the dog. Before you say “Yes” to bringing a dog into your home, please consider these things. It will likely cost you money (food, grooming, leash/harness or other equipment) which is reimbursable, and will definitely require patience and diligence in the dog’s vetting, rehabilitation & training.

Type of Residence
HouseTownhome/TwinhomeApartment

If you live in a rental unit, we will need a letter from your landlord granting authority to have a dog on the property.

Do you have a fenced yard?
YesNo

If you answered yes, please describe your fence. (please answer N/A if you do not have a fence)

Do you have a swimming pool?
YesNo

If you answered yes, is it fenced? (please select N/A if you do not have a swimming pool)
YesNoN/A

Do you have restrictions regarding pets in your association or neighborhood (or building, if you rent)?
YesNo

Does your city or town have restrictions on the number of pets you can own?
YesNo

Are you planning on moving in the near future?
YesNo

If you answered yes, will you look for housing where pets are allowed? (please select N/A if you are not moving in the near future)
YesNoN/A

Do you or anyone in your household smoke? (Allergies or breathing issues may prevent some of our dogs from being in homes with smokers.)
YesNoYes, but not in the house

Please list all residents in your home (including yourself) and their ages.

Do you have children, grandchildren or other individuals besides those listed above that will be frequently visiting?
YesNo

If yes, please describe. (please answer N/A if you will not have others visiting your home)

Preferences

Briefly explain why you want to adopt a Shih Tzu.

Are you willing to adopt a dog that may have experienced some form of abuse or neglect?
This dog might require extra patience and love to address shyness and fears.
YesNo

Are you willing to adopt a dog with special medical needs?
YesNoMaybe

Are you willing to adopt a Shih Tzu/mixed blend?
YesNoMaybe

Have you ever had a Shih Tzu before?
YesNo

Care & Responsibility

Are you aware of the special grooming needs of a Shih Tzu?
YesNo

Are you willing to pay a groomer to groom your dog every 6-8 weeks?
YesNo

Are you willing to brush the dog’s coat and clean the eyes daily if needed?
YesNo

How many hours would your dog be left alone each day?

Where will the dog be kept when you are not home?

If you work a full time schedule, if need be, could you come home at lunch or have someone check on the dog for you?
YesNo

Who will watch your dog when you are out of town or on vacation?

Where will your Shih Tzu sleep at night?

Who will have primary responsibility for caring for the dog?

Does anyone in your home have allergies?
YesNo

What will you do if a family member or a current pet does not get along with your new Shih Tzu?

Please describe your method of discipline for a dog:

Are you willing to house train or retrain your new Shih Tzu? NorthStar cannot guarantee any dog is 100% house trained. Most have begun training in their foster homes. However, all dogs (not just rescue dogs) need retraining to some extent as they adjust to new surroundings, new sleeping patterns, new feeding routines, and new family life. We also recommend any dog under one year be enrolled in a basic obedience class to aid in socialization and behavior.
YesNo

Pet Ownership

Are there other pets in your household? (Please provide species, breed, sex, spayed/neutered, and age. Please answer N/A if you have no other pets in your household.)

Tell us about the pets you have had in the past and what happened to them. (please answer N/A if you have not owned pets in the past)

Is there any other information you would like to share with us about your desire to adopt or the type
of Shih Tzu you would like? (please answer N/A if this does not apply to you)

References

Please provide the names of three references we can contact for information about you, your family and pets. If you have a veterinarian and groomer, please include them in your references. Only one relative may be used. If you rent, you must include your landlord as a 4th reference. Please contact your references to let them know they will be called.

Veterinarian/Clinic (First and Last) (please answer N/A if you do not have a vet)

Veterinarian/Clinic Phone (please answer N/A if you do not have a vet)

Veterinarian/Clinic Address (please answer N/A if you do not have a vet)

Groomer (First and Last) (please answer N/A if you do not have a groomer)

Groomer Phone (please answer N/A if you do not have a groomer)

Groomer Address (please answer N/A if you do not have a groomer)

Landlord (First and Last) (please answer N/A if you do not rent)

Landlord Phone (please answer N/A if you do not rent)

Landlord Address (please answer N/A if you do not rent)

Reference No. 1 Name (First and Last)

Reference No. 1 Phone

Reference No. 1 Relationship to you

Reference No. 2 Name (First and Last)

Reference No. 2 Phone

Reference No. 2 Relationship to you

Reference No. 3 Name (First and Last)

Reference No. 3 Phone

Reference No. 3 Relationship to you

I certify that the above information is true and accurate and I have not omitted any information. I understand the omission or falsifying of any of my information will result with my ineligibility to adopt.

Please Enter Your First and Last Name

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