Your Name               

Street Address      City       State       Zip  

Email Address       Phone             

If you are not within driving distance of St. Helens, Oregon will you want to have the puppy shipped to your local airport? Yes   No

Is this pug for you or someone else?  Just for me  For a gift

(NW Pugs highly recommends not giving pets as gifts unless it is to someone that lives in your household so that you can make sure that the puppy is wanted and well cared for.  Many dogs in local shelters started out as a well-meaning gift that did not work out.)

Are you ready to get your pug right away if one is available?               Yes  No

Would you like to be put on our waiting list if a pug is not available right away?               Yes   No

I want a:               Older Dog  Puppy  No Preference

I would like a:  Pet Quality   Show/Breed Quality

I want a:               Female   Male  Either

My preference is:  Fawn   Black  No Preference

I live in a:  House  Apartment  Condo  Other

                         Own   Lease   Rent  

(If you lease or rent we would like to contact your landlord to verify that pets are okay, may we contact your landlord?Yes   No

                           Landlord Name & Phone Number

My Yard is:  Fenced  Not Fenced  Partially Fenced               I am building a Fence now                  

Do you have Children that live with you?                          Yes  No

                         If "yes" what are their ages?

Do you have other pets in the home?  Yes   No

   If "yes" what type and how many of each?

Where will you keep the pug as a puppy and once it is grown?

   (outdoors, in the house etc.) 

Who will mostly be providing the care for the pug?              Me  My spouse The kids  My Roommate

How much time alone will the pug have while you are at work each day?              

Where will the pug be during your work hours? 

Have you found a vet that is experienced with Pugs specifically?  Yes   No

This is a very important step as there are many that are not experienced with pugs and their need for special anesthesia for any surgical procedures.)

Are you aware and willing to deal with the fact that pugs shed all the time?   Yes   No

Are you aware that pugs have many inherited traits that may lead to high cost vet bills?  Yes  No

                     Click here to see what some of these things are

Why do you want a pug?

  PLEASE FILL THIS SECTION OUT - it is an important part of the application process. Typing space is limited to the size of this box, anything that goes over that cannot be viewed by NW Pugs. There is a 625 character limit.

If you fill this out and it doesn't work, don't try it again. For some people it just won't work.

If your having problems please contact me directly at nwpugs@opusnet.com