NC Yorkie Rescue: Adoption Application

First and Last Name (Applicant) must provide BOTH First and last names *

What is your age? *

Preferred Phone *

Occupation *

Place of Business *

Email *

First and Last Name (Co-Applicant)

Occupation *

Their age? *

Homeowner Details

Street Address (Home) *

City *

ST *

ZIP *

Are there children (under 18) living in this home? *

Yes

No

Expecting a Child/Grandchild

Do you watch children in your home on a regular basis?

If yes, names/ages of children under 18:

I understand that NC Yorkie Rescue does not adopt dogs into homes with children under age 8 and to those who keep children under the age of 8 on a regular basis. *

Yes

No

I live in a (choose one): *

House

Townhouse/Condo

Apartment

Do you own or rent? *

Own

Rent

How Long Have You Lived At This Address? *

I understand that NC Yorkie Rescue will consider applicants that are renting homes if they provide letter from landlord stating dogs are allowed on premises. *

Yes

No

Does your home have an enclosed fence? *

Yes

No

If you have a fence, what is the type and height?

Pet Selection

I want to adopt a Yorkie because... *

I want a: *

Male

Female

Either

I want a: *

Puppy (0-2 Years)

Young Dog (2-7 Years)

Senior Dog (8-12 Years)

Any Age

I want a: *

Small (under 5 lbs)

Mid-Size (5-9lbs)

Large (10 lbs)

Any Weight

If you are interested in a specific dog, which one(s)?

I would like to bring a dog home: *

Immediately (within 7 Days)

Within 30 Days

Next Month or Later

Do you own (or have you owned) a Yorkie? *

Yes

No

How many HOURS PER DAY will the dog be alone? *

When the dog is home alone, he/she will: *

Be Crated

Stay in Gated Area

Have Free Run of House

The dog will sleep: *

Pet Owner History

Current (or most Recent) Veterinarian's Name *

Vet Phone Number *

I understand that NC Yorkie Rescue will contact this Vet to gather details about my pet owner history. *

Yes

No

Do you have other pets now? *

Yes

No

If yes, please list the name(s), age(s) and breed(s).

If the pet is deceased, how did he/she pass away?

Is (was) your dog spayed or neutered?

Yes

No

Is (was) your dog on heartworm preventative?

Yes

No

Is (was) your dog current on all vaccines?

Yes

No

Is (was) your dog microchipped?

Yes

No

Home & Family Photos

As part of the application process, NC Yorkie Rescue Inc. requests photos of:

1. the home's front yard, back yard, enclosed/fenced area, and main living area

2. each person living in the home, including children or grandchildren under age 18

3. any pet(s) that live in the home

***If photos are not received within 7 days of application, your application will be denied

I agree to submit photos to ncyrphotos@gmail.com and understand that if photos are not received within 3 days of my application, it will automatically be denied *

Yes,

No

Acknowledgements

1. 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 NC Yorkie Rescue, Inc has the right to deny my application.

2. I am financially able to care for this animal. I understand that proper food and veterinarian care is costly and I am able to meet these requirements.

3. I am physically able to care for and exercise this animal.

4. I understand that home checks may occur randomly prior to, during or following the adoption process. If, upon inspection, we find that information contained in this application is false, NC Yorkie Rescue Inc. retains the right to remove the animal from your premises without a refund of the adoption fee.

Please note, we do not adopt dogs into homes of people that smoke/vape to protect the lungs of the animals entrusted in our care.

What happens once I apply?

Once we receive your application, we will contact your vet for a reference check to be sure your pet has had regular yearly check-up, if they have been spayed or neutered, if they are current on vaccinations and if they are are on Heartworm prevention.

***Please note: If you current pets are not spayed or neutered, your application will not be approved.

Do you allow renters to adopt?

If you rent, we will consider your application if you supply a letter, with the property's letterhead, from your landlord in which they allow pets to reside on the premises showing any pet deposits that must be paid.

Are fences required?

While fences are preferred, they are not required in all cases. Yorkies were originally bred to chase rats in Yorkshire, England (hence why they are called Yorkies) so it is in their nature to chase anything small and moving. For this reason, walking your dog on a lead is a must. Yorkies are also easy prey to flying predators such as owls and hawks so allowing them to be unsupervised even in a fenced yard leaves them vulnerable to such attacks.

IF I HAVE CHILDREN UNDER THE AGE OF 8, WILL I BE ALLOWED TO ADOPT?

No, the rescue does not adopt to families with children under the age of 8 for the children's safety as well as the dog's safety

Full Legal Name (as appears on Driver's License/ID which is required at pet pick-up): *