Adoption Application — PCCV Rescue

Section 1

Applicant & Household Information

Who you are and who shares your home.

Full name *

Email *

Phone *

City and state *

Street address

Who lives in your household, including ages of any children? *

What other pets live with you now?

Section 2

Your Life With a Pomeranian

Open-ended questions — please answer in your own words.

Tell us about your life *

Why a Pomeranian? *

Describe a typical day in your home *

Section 3

Personality Matching

Tell us what you are hoping for so we can suggest the right dog.

Section 4

Home & Care

How a Pomeranian would live day to day with you.

Housing situation *

Do you own or rent? *

Describe your yard and containment (fencing, leash routine, etc.) *

Plans for exercise and enrichment *

Plans for grooming and coat care *

Plans for routine and emergency veterinary care *

How many hours would the dog typically be alone, and where would they be? *

Section 5

Veterinary Reference

We contact your veterinarian as part of the review.

Veterinarian name *

Clinic name *

Clinic phone *

Clinic city and state

May we contact this clinic, and is there anything we should know first? *

Section 6

Acknowledgment & Signature

An editable acknowledgment statement will be supplied by PCCV.

Placeholder acknowledgment: by submitting this application I confirm that the information provided is accurate and understand that submitting an application does not guarantee placement of a dog. PCCV will replace this wording with its official statement.

Typed signature *

Date *

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