Yorkie Rescue of the Carolinas Adoption Application

Are you applying for a specific dog? If so, please provide name of dog applying for. If not, just type "ANY". *

Are you willing to adopt a dog who has special needs? (Many of our rescues have behavioral or health issues that may require daily medications, special diet, or treatments. Please let us know if you are open to adopt one of our special needs babies) *

First Name *

Last Name *

Email address *

Home phone number *

Cell phone number *

How long have you lived here? *

Home Street Address: *

City, State, and Zip Code *

Type of residence *

Home

Apartment

Condo/Townhouse

Mobile Home

Own or Rent *

Own

Rent

If rent, please provide landlord's name and phone number If rent, please provide landlord's name and phone number

Is your yard fenced? *

Yes

What type of fence do you have? *

Which would you prefer: *

Male

Female

Either

Are you an experienced dog parent? *

Yes

Many rescues and/or young puppies are not house trained. Are you prepared for the possibility of your new fur baby making messes in your house? *

Yes

What type of correction methods do you use? *

What will you do if the dog makes a big mess or tears up something valuable? *

Names and age of ALL individuals living in the household *

Occupation *

Workplace Name: Address: Job Title: *

Number of hours away from home per day *

Where will the dog stay while no one is home? *

Where will he/she sleep at night? *

Do you have pets now? *

Yes

If yes, list breed(s) and age(s) of all current pets in the home.
*Also, please tell us a little bit about any dogs you have had in the past* *

Are your pets spayed or neutered? *

Yes

Are your pets up to date on vaccines? *

Yes

Are you financially able to provide for all your pet's future needs, including good quality food, grooming, any potential health care requirements, and future vet visits? *

Yes

Have you ever had a pet die? If so, please give a brief description of how your pet(s) died? *

Please provide your veterinarian's name, address, and phone number.
If you do not currently have a vet please select one that you will use and provide that vet's information.
*WE WILL DO A VET CHECK, SO PLEASE CALL YOUR VET AND GIVE PERMISSION FOR THEM TO SPEAK WITH US*
Applications with incomplete vet information will not be considered. *

What will happen to your dog in the event you have an unexpected emergency and cannot be home for an extended period of time? *

What happens to your pet(s) if you die before they do? *

Do you have a Facebook page? If so, what name is it listed under? *

How did you hear about Yorkie Rescue of the Carolinas? *

Do you understand that you need to submit photos of your home, yard, everyone that resides in your home, and the pet's living, eating and sleeping areas to our email (cynthiayroc@gmail.com) in order to complete your application? *

To complete your application please submit photos of your home's main living area, pet's sleeping and eating area, and yard (all areas where pet will be living and/or spending time) as well as photos of everyone who lives in the home, including pets. EMAIL PHOTOS to YorkieROC@gmail.com.
*Applications without photos will not be considered.*

I certify that the information provided in this form is true and accurate. If the information contained in this application is found to be false, I understand that Yorkie Rescue of the Carolinas has the right to deny my application. Furthermore, I attest to the following:
1) I am financially able to pay for all future food, supplies, housing, vet visits and/or medical care for the dog.
2) I am physically capable to care for and exercise the dog daily.
3) I understand that a home visit may occur prior to, during or following the adoption process. If it is discovered that information contained in this application is false or if the animal is not being cared for properly (by providing food, fresh water, sanitary hygiene, etc) Yorkie Rescue of the Carolinas retains the right to remove the animal from my premises immediately without refund of adoption fee.

Electronic signature *Full Name and Date*: *