Adoption Application

Interested in adding a family member? How does the adoption process work? Good question! The first step is completing our adoption application which is generally reviewed within 24 hours of receiving. If at any point in the process you have any questions please contact us at [email protected]. After submitting your application a representative will review and contact you to discuss the animal and answer questions. If your application is approved, a home visit is scheduled where the adoption is usually finalized. n nBefore proceeding with the adoption application you must be at least 21 years old.

"*" indicates required fields

Applicant First Name:*

Applicant Last Name:*

Address:*

City:*

State:*

Zip Code:*

How long have you live at this address?*

Prior address: (if less than 3 years)

Email Address:*

Contact Phone #1:*

Contact Phone #2:

What is the best time to call?*

Applicant Employer Name:*

Applicant Occupation:*

Spouse/ Partner name:*

Please list all household members, age, and relation to applicant:*

# of children (under 18) in the home:

Spouse/ Partner occupation:

Do young children visit regularly?

(other than household members)

If yes, please list age and relation to applicant:

What type of home do you live in?*

Do you own your home?*

Do you have a backyard?*

If yes, is the backyard fenced?

What type of fence?

Height of fence:

Is the fence permanent?

Is the gate secured with a lock?

Is there a pool or pond in your yard?*

If yes, please describe the pool or pond and the safety measures taken to prevent drowning:

Why do you want to adopt?*

What do you know of the breeds health, grooming, and temperament??*

Are all household members supporting the adoption?*

If not, please explain:

Are you interested in a specific dog?*

If yes, please list the name:

Do you prefer a male or female?*

What age do you prefer?*

When will the yorkie be left alone? For how long? And will they be crated?*

Will the yorkie primarily live inside or outside?*

If outside, is it:*

How long do you plan to keep the yorkie?*

How will you handle problems with behavior (potty training, etc.)?*

Under what circumstances would you give up the yorkie?*

Have you ever owned a yorkie?*

If so, where is it now?

What other pets have you owned in the last 10 years and where are they now?

Are there other pets in your home?*

If so, please list species, age, and sex:

Are all the pets in your home spayed or neutered?

Are any of the pets in your home aggressive? Have they bitten another person or animal?

If so, please explain the circumstances:

Have you ever been convicted of a crime involving and animal?

References

Reference #1 Name:*

Relation to applicant:*

Phone number:*

Reference #2 Name:*

Relation to applicant:*

Phone number:*

Reference #3 Name:*

Relation to applicant:*

Phone Number:*

I declare that the information I have provided in this application is complete and correct. I understand that any false information provided will invalidate this and any future applications. I acknowledge that I am at least 21 years of age or older, financially and physically able to care for a rescued dog. I understand that proper food and veterinarian care may be costly, and I am able and willing to meet the needs of my adoptive dog. I understand the requirements and grant permission for Home Checks at random, both prior to and following adoption. I submit that if a Home Check reveals falsification or misrepresentation of any facts on my part, Yorkie Luv Rescue reserves the right to either refuse adoption or to nullify the adoption and reclaim said dog from my premises without reimbursement of the adoption donation. I release Yorkie Luv Rescue from any liabilities I may incur from the adoption process.*

I agree