Application for Adoption
Name: Age:
Spouse: Age:
Address:
City: State: Zip Code:
Email Address (example: [email protected]):
Home Phone: Cell Phone:
Your Employer: Work Phone:
Number of Children/Grandchildren: Their Ages:
How long have you lived at your current address?
Do you: (Circle one) Own Rent Other
If Other, please explain:
If Rent, Name of Landlord:
Landlord�s Phone:
Current housing: House Condo/Townhouse Mobile Home Apartment
What type of environment? : Urban Suburban Rural
If less than two years at current address please list previous address:
Does your Current home have a yard? Yes No
Is it fenced: No Yes - What type of fence and how tall? :
To feed, vaccinate, license and provide medical care for this animal, what do you anticipate spending yearly? $200 $300 $400 or more
Consider the following prices: One vet office visit = $35 = $ 35.00 annual shots = $20 each x 3 = $ 60.00 necessary annual dental cleaning = $200.00 plus food, toys, bed, grooming, medication, neutering or spaying, sick dog visit, x-rays, blood work, etc. Can you afford to care for a Yorkie?
Adoption Information
Which member or members of your household will feed and care for this animal?
Is someone home during the day? (Circle One) Yes No Part of the day
If No one is home during the day, where will the dog stay while you are gone?
This animal will be alone for how many hours a day? hours
When you do go away for a few days, who will care for this animal?
Where will your dog be kept most of the time?
Will YOU go to obedience class and take your dog? Yes No Why not?
Have you ever owned a Yorkie? Yes No
If Yes, where is that Yorkie now?
Do you prefer Male Female Either Explain your choice on back.
Age range? (NOTE: WE NEVER EVER GET PUPPIES IN RESCUE!) ___ years to ___ years or doesn�t matter.
Would you consider adopting more than one if they came together? Yes Maybe
Have you ever given up a dog or taken a pet of yours? Yes Explain on back
Yorkies are (1) almost impossible to housetrain, (2) do not get along well with children and (3 very attached to their guardians and can suffer separation anxiety.
Reputable breeders have puppies for sale. Why do you want to adopt a Yorkshire Terrier?
Would you provide a temporary Foster Home? This is VERY Important! Please consider this question carefully. All of our dogs go to foster homes FIRST before they are adopted. The foster family always has first right to keep and adopt the dog. It is the best way to find out if the dog is compatible with your family. If you have questions about fostering; please ask. We have to look for people who don�t love the dogs much. MANY people tell us that they love dogs so much they WON�T foster one. This doesn�t make sense to us. We need foster homes more than we need money!
Other Pet Information
Do you have other pets? Yes No
If Yes, list type (breed, age, sex):
Are all other pets current on all vaccinations? Yes No
Are your other pets spayed/neutered? Yes No
Are your animals on Heartworm preventative? Yes No
If Yes, what type? :
Veterinarian�s Name: Phone:
Name that animals are under at the vet�s office (pet�s name and owner�s name)
List the pets you have owned in the past three years and what happened to them:
List any Humane Societies, Organizations, Breed or Training Clubs you are associated with:
Please provide the name, address and phone number of three references:
Name: Phone:
Name: Phone:
Name: Phone:
