Application Form

Thank you for applying to our organization, Lend A Helping Paw Shih Tzu Rescue (LAHPSTR), to adopt, foster or volunteer. The process is identical to adopt, foster or volunteer.

While the adoption process of LAHPSTR may seem too involved and at times, intrusive, it is designed to protect our dogs and find the best homes for them. Adopting a rescued dog is a commitment for the life of the companion animal and we want to ensure our dogs go to loving, committed and responsible adopters.

Incomplete submissions will not be processed. We reserve the right to deny an application and revoke approval for any reason at any time at our sole discretion. Additional agreements are required for foster parents and volunteers after approval.

Our turnaround time for a reply is typically 5 to 7 business days after we receive all your documents, although there may be a longer delay during certain periods. Please understand that we are an all-volunteer group who rescue around personal and professional obligations. We appreciate your patience. You may contact us for a status update or any other inquiry through this website.

Lend A Helping Paw Shih Tzu Rescue Application Form

To adopt, foster or volunteer

- Step 1 of 9

Applicant Information

I acknowledge that I have fully read the information on this webpage above this application form regarding the adoption policy and application process of Lend A Helping Paw Shih Tzu Rescue. *

• Yes
• No

I understand that an acknowledgement email with further instructions is automatically sent to me after I submit this application form. *

• Yes
• No

Name *

First

Last

Date of Birth *

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Email *

Email

Confirm Email

Primary Phone *

Alternative Phone

Address *

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Occupation *

Employer *

Employer Address *

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Work Email

Work Phone

Co-Applicant Information

Adults living at home and students of legal age (at least 18) must have a co-applicant.

Do you have a Co-Applicant? *

• Yes
• No

Co-Applicant's Name *

First

Last

Co-Applicant's Date of Birth *

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Email *

Email

Confirm Email

Co-Applicant's Primary Phone *

Co-Applicant's Alternative Phone

Does Co-Applicant live at the same address as applicant? *

• Yes
• No

Co-Applicant's Address *

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Co-Applicant's Occupation *

Co-Applicant's Employer *

Co-Applicant's Employer Address *

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Co-Applicant's Work Email

Co-Applicant's Work Phone

Will any adopted dog be a gift for someone who is not the applicant or co-applicant? *

• Yes
• No

If Yes, for whom is the dog intended? *

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Your Household

Do other people (excluding any co-applicant) live in your household? *

• Yes
• No

Is there complete household buy-in for this adoption? *

• Yes
• No
• Not sure

Who will be the dog's primary caregiver? *

Do children under the age of sixteen (16) live with you or visit your home? *

• Yes
• No

Have the children been around animals before? *

• Yes
• No

Please tell us about the people who live with you or who visit your home frequently. Please include ALL immediate and extended family, neighbors, friends, etc. For frequency, please indicate: 1) Lives with me full-time, 2) Visits about weekly, 3) Visits about monthly, 4) Visits less than monthly

Person 1

Name

First

Last

Relationship to You

Age

Frequency of Visits

1) Lives with me full-time, 2) Visits about weekly, 3) Visits about monthly, 4) Visits less than monthly

Person 2

Name

First

Last

Relationship to You

Age

Frequency of Visits

1) Lives with me full-time, 2) Visits about weekly, 3) Visits about monthly, 4) Visits less than monthly

Person 3

Name

First

Last

Relationship to You

Age

Frequency of Visits

1) Lives with me full-time, 2) Visits about weekly, 3) Visits about monthly, 4) Visits less than monthly

Person 4

Name

First

Last

Relationship to You

Age

Frequency of Visits

1) Lives with me full-time, 2) Visits about weekly, 3) Visits about monthly, 4) Visits less than monthly

Do you or anyone in your household have any allergies? *

• Yes
• No

Do you or anyone in your household smoke? *

• Yes
• No

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Your Home

What best describes your current residence? *

• Single-family home
• Townhome or Condominium
• Apartment
• Mobile Home

Do you own or rent your home? *

• Own
• Rent

If renting, does your landlord allow dogs? *

• Yes
• No

If renting, please provide the name and phone number of your landlord. *

Do you have a fully fenced yard? *

• Yes
• No

Height and type of fence *

If you do not have a securely fenced yard, how will you ensure the safety of your dog? *

Do you have any of the following? Select all that apply. *

• Dog door
• Dog run
• Underground fence
• None

Do you have a pool? *

• Yes
• No

If you have a pool, how will you keep a dog safe? *

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Current Dogs

Do you currently own a dog? *

• Yes
• No

Dog 1

Name *

Breed *

Age *

Male or Female? *

• Male
• Female

Neutered or Spayed? *

• Yes
• No

Where did you get them? *

How long have you had them? *

Dog 2

Name

Breed

Age

Male or Female?

• Male
• Female

Neutered or Spayed?

• Yes
• No

Where did you get them?

How long have you had them?

Additional Dogs

Please list all other dogs you currently own (# - Name - Breed - Age -Male/Female - Neutered/Spayed - Where from - How long owned).

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Past Dogs

Have you ever owned a dog in the past? *

• Yes
• No

Dog 1

Name *

Breed *

Where did you get them? *

How long did you have them? *

What happened to them? *

Dog 2

Name

Breed

Where did you get them?

How long did you have them?

What happened to them?

Additional Dogs

Please list all other dogs you have had as an adult.

Have you ever given up a dog before? *

• Yes
• No

If yes, under what circumstances? *

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New Dog Information

Why do you want a dog? *

Does your current lifestyle allow you to dedicate time and energy to a new dog? *

• Yes
• No

What is your preferred age range for a new dog? *

List any personality traits you would like to see in the new dog. *

List any personality traits you do NOT want in the new dog. *

Where will the new dog sleep at night? *

Where will the new dog stay when nobody is home? *

How many hours in a normal day will the new dog be left alone, without a human to let them out for bathroom breaks and without supervision? *

Who will take care of the new dog when you are out of town? *

What length of time will you allow the new dog to adjust to their new home? *

Are you aware that a new environment may be stressful for a new dog and cause them to exhibit uncharacteristic behavior? *

• Yes
• No

Are you willing to work through any potential challenges and hiccups with the new dog? *

• Yes
• No

What will you do if your current dog(s) and new dog do not get along? *

Have you ever house-broken a dog or puppy before? *

• Yes
• No

Although the majority of our dogs are crate-trained or trained to the routine and schedule of their foster homes, most dogs will need to be re-housetrained to your home and your routine. How do you plan to housetrain the new dog? *

If the new dog has an "accident" in your home, what type of correction do you plan to use? *

Although we do not take people-aggressive dogs into our program, we do accept abused and unsocialized dogs. These dogs often need work with behavior problems. Any dog that has ANY known history of snapping will not be adopted to a family with children. However, understand that a dog may react differently in a new environment and you must be prepared to deal with it. How do you feel about a dog that exhibits behavioral problems such as snapping and biting and how will you deal with such behavior? *

What will you do if the dog bites your child or a friend's child? *

75% of dog bite cases involve dogs that have never bitten anyone before and you, as the dog owner or guardian, must take whatever measures are necessary to avoid putting the new dog in a situation where the dog might become afraid and snap. I understand this and will protect the dog from these situations. *

• Yes
• No

Do you plan to take an obedience class with your dog? *

• Yes
• No
• Unsure

Do you understand that it may cost $1,200 or more annually to care for a dog, including regular grooming and normal veterinary care? *

• Yes
• No

Are you financially capable of taking care of an ill or injured dog? Veterinary care can cost hundreds of dollars. Elaborate on how you intend to provide routine and non-routine medical care. *

Would you adopt a dog with minor health issues such as dry eye, allergies and thyroid problems that might necessitate a pill or drops daily, or monthly injections? *

• Yes
• No

Would you adopt a dog with health issues such as diabetes and kidney disease that might necessitate a special diet and a medication regimen on a daily basis? *

• Yes
• No

What circumstances would lead you to give up the new dog? *

If you had to give up the new dog, what would you do with them? *

Shih Tzu and other small dogs can easily live 17 to 18 years. Who will take care of your dog if something should happen to you and you can no longer take care of the new dog? Please provide contact details below. *

Do you understand that LAHPSTR contractually requires regular updates with photographs and/or videos about the new dog for its lifetime? *

• Yes
• No

Do you give your permission to a LAHPSTR Representative to visit your house prior to an adoption to do a Home Visit, and after the adoption to do follow-up checks on the dog? *

• Yes
• No

How did you hear about LAHPSTR? Select all that apply. *

• Facebook
• Instagram
• Twitter
• YouTube
• Online search
• Petfinder
• Referral
• Word of mouth
• Other

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References

Are you a first-time dog owner? *

• Yes
• No

Veterinarian Information

Vet Name and Clinic *

Vet Phone *

Name on the account *

How long have you seen this vet? *

Pets they have seen *

Will you call your vet to authorize them to release complete medical information about all of your animals to Lend A Helping Paw Shih Tzu Rescue and/or discuss with representatives of LAHPSTR? *

• Yes
• No

Do you authorize us to contact your vet? *

• Yes
• No

Personal References

Reference 1

Name *

First

Last

Years known *

Phone *

Email *

Email

Confirm Email

What type of pets do they have? *

• Dogs
• Cats
• Other
• None

Reference 2

Name *

First

Last

Years known *

Phone *

Email *

Email

Confirm Email

What type of pets do they have? *

• Dogs
• Cats
• Other
• None

Reference 3

Name *

First

Last

Years known *

Phone *

Email *

Email

Confirm Email

What type of pets do they have? *

• Dogs
• Cats
• Other
• None

Is there anything else that you would like for us to consider when processing your application? *

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Adoption Donation

The adoption donation varies according to age. Our dogs are rescued and we often do not know their actual ages. Estimation of the age of a dog is not an exact science. We use reasonable efforts to derive approximate ages based on the advice of our veterinarians and our experience. LAHPSTR makes no affirmative representation that the approximate age is the actual age of the dog.

Do you understand that LAHPSTR makes no guarantee as to the ages of our dogs? *

• Yes
• No

I understand that the adoption donation is between $150 and $1050. *

• Yes
• No

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Declaration

I affirm and certify that all the information and answers to questions herein are complete, true and correct to the best of my knowledge and belief. I understand that any misrepresentation, falsification, or omission of any facts called for in the application may render this application void and will be cause for denial or revocation of approval, whenever discovered. *

• Yes
• No

I affirm that I will treat an adopted dog with love, respect and kindness; keep them safe from harm; and tend to all their needs, including, but not limited to, high-quality food, clean water, indoor shelter, grooming, and medical care. *

• Yes
• No

I further certify that I have never been accused or convicted of animal cruelty or abuse. *

• Yes
• No

By signing this Application Form electronically, I agree that my electronic signature is the legal equivalent of my manual signature on this Application Form. *

Date *

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