XOLO Rescue

Prospective Owner Application

XR ID#            

Thank you for your interest in adopting a Xoloitzcuintle or honorary Xolo. Please complete this form so we can best determine the suitability of you and your family for a XOLO. If any answers need further explanation: please use additional pages. (You will need to print and fill out the application at the present time. It can then be sent to Xolo Rescue C/O Kim Lovewell at 10642 N. 68th Place, Scottsdale, AZ 85254-5224)

Name

Phone (Day) (Evening)

Address

City

Zip

Email

Fax

Best time for us to call you?

Occupation:

Length of Employment?

Do you Rent or Own?

House

Apartment

Condo

Mobile Home

Other

If you rent, name and phone number of landlord:

 

Personal Information:

Your Age

Ages of Other Adults in Your Home

Are all adults in your household agreeable to you having a hairless dog? Yes no

Are there children under 18 years in your household? Yes no Ages?
Are there children who visit regularly? Yes no Ages?
Do you own other dogs? Yes no How many?
Do you own other cats? Yes no How many?
List breed, sex and age of each dog you own:
Breed	Sex		Age	Spayed or Neutered?
List breed, sex and age of each cat you own:
Breed	Sex		Age	Spayed or Neutered?
What happened to the last dog you owned but no longer have?
Name of your current veterinarian:
Address and phone:

Why do you think you would like to own a Xoloitzcuintle or hairless dog?

Are you familiar with the sizes, characteristics and temperament of Xoloitzcuintle? Yes No

Do you know how to care for and groom a Xolo? Yes No

If no to either question, will you be willing to learn and to call a member of Xolo Rescue, or the Xolo Club USA                      (XCUSA) if you have questions or concerns about the care of your Xolo? Yes No

Have you ever owned a hairless breed before? (Describe)

Are you committed to caring for your next dog for its lifetime? yes no

Have you ever raised a puppy from 8 weeks to adulthood? yes no

How many hours a day will your dog be left alone?
Where will the dog stay during the day?
At night?
Do you have a fenced yard or enclosed are where the dog can run safely for exercise?
If not, what arrangements will you make for exercise and potty duties?
Do you have a preference as to age?				Sex?			Size?

Do you understand that your dog will have been surgically sterilized before adoption? yes no

Would you be willing to adopt a Xolo with a handicap or medical problems? yes no

Do you consider yourself financially stable enough to prove proper diet, medical care and housing for a Xoloitzcuintle,          including emergency treatment if needed? yes no

Would you be willing to have a Xolo Rescue or XCUSA representative visit your home by appointment? yes no

How did you hear about Xolo Rescue and it’s adoption program?

Please give us the name of someone you know and who knows you, who might be "in dogs" (Someone who shows                     their dogs or competes in obedience, agility or other events with their dogs.)

Name:

Phone:

 Personal (character) reference:

Relationship:
Name:		Phone:
Address:

 Your signature:                                                                                                                                                

Today’s Date:                                                                                                                                                   

 

WE RESERVE THE RIGHT TO REFUSE ANY APPLICANT.

Please use the space below for any other information which may be helpful to us in determining whether to place a

Xolo with you.