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To apply to adopt with YHR, you must be at least 25 years of age and have demonstrated responsible pet ownership.

Our adoption fees are based on the age, size and medical status of the pup and range from $150 to $600. The fees listed are not negotiable and hardly ever compensate for the pup's vetting.

After completion of the application, you will receive an email informing you that the application has been received. If your application is being considered for one of the YHR pups, you will be contacted (via email or telephone) for more information. YHR also checks with your veterinarian, personal references, landlord (in case of renters) and performs a home visit prior to approval. Just because an application is submitted, does not mean you are approved for adoption.

Yorkie Haven Rescue reserves the right to refuse adoption to any applicant for any reason.
       
SECTION 1 - PERSONAL INFORMATION
First Name: Last Name:
Address 1:    
Address 2: City:
State: Zip:
Work Phone:    
Home Phone:    
Cell Phone:    
       
Age: E-Mail:
       
Employer: Occupation:
Length of Employment:
Please list names, ages and relationship of all people living with you in your household:
How long have you lived at your current address?
Do you plan to move within the next 12 months?
Do children/grandchildren visit your home?   What ages are they? How often do they visit?
Does anyone in your household experience any known allergies other than food allergies?
If yes, who?  To what?
Are all family members in agreement about getting a new pet? 
       
SECTION 2 - ENVIRONMENT INFORMATION
       
Which best describes your home?
I/We:    
If you rent, name and phone number of landlord:
If you live in an apartment, name of complex: Complex phone number:
Are pets allowed where you live?  
Where will this pet be kept most of the time?
Is someone home during the day?
How many hours per day will the dog be home without supervision?
Work Days: Non Work Days:
       
Where will this dog spend his/her daytime hours?
Does your home have a:    
Pool?    
Doggy Door?    
Fenced Yard?    
Type of Fence: Height:
       
Condition of fence: Any gaps/ holes/ missing or broken boards?
If you do not have a securely fenced yard, tell us what measures you will take to ensure that the pet will not run off, get hit by a car, be attacked by a stray or wild animal, irritate your neighbors, or otherwise be a problem:
How long do you plan to have this pet?
   
SECTION 3 - PUP INTERESTED IN ADOPTING
   
Pup interested in adopting:
Why do you want to adopt a yorkie?
If the dog is not housebroken, how will you train it?
Are you willing to groom or have this pet groomed on a regular basis?
What do you consider a valid reason(s) for giving up a pet?
Would you ever consider giving up your pup due to age or medical issues?
Where will this dog sleep at night?
What arrangements will you make to ensure the health, safety and well-being of this dog if you are out of town whether for business or vacation?
If this dog develops behavior problems (chewing, digging, etc), what measures will you take?  
How long do you expect the dog's adjustment to a new home and family to take?
If you lost your job, had to move, or had a baby what would you do with this pet?
       
SECTION 4 - CURRENT PET INFORMATION
       
Have any adults in your household ever surrendered/had to give up a pet(s)? When, why, and to whom?
Do you currently have other pets?
If yes, please complete below information for EACH pet you own.  If you have no current pets, please skip to Section 5.
       
Current Pet #1    
Pet Name:    
Breed: Age:
Gender: Spayed/Neutered?
How long have you had this pet?
Where did you acquire this pet?
Obedience trained?    
On Heartworm Preventative? If yes, what kind?
Where does this pet spend the daytime hours?
  Evening Hours:
Where does this pet sleep?
Name of Vet where records for this pet can be obtained:
  Vet Phone Number:  
When / Why was your last veterinarian visit?
Current Pet #2    
Pet Name:    
Breed: Age:
Gender: Spayed/Neutered?
How long have you had this pet?
Where did you acquire this pet?
Obedience trained?    
On Heartworm Preventative? If yes, what kind?
Where does this pet spend the daytime hours?
  Evening Hours:
Where does this pet sleep?
Name of Vet where records for this pet can be obtained:
  Vet Phone Number:  
When / Why was your last veterinarian visit?
Current Pet #3    
Pet Name:    
Breed: Age:
Gender: Spayed/Neutered?
How long have you had this pet?
Where did you acquire this pet?
Obedience trained?    
On Heartworm Preventative? If yes, what kind?
Where does this pet spend the daytime hours?
  Evening Hours:
Where does this pet sleep?
Name of Vet where records for this pet can be obtained:
  Vet Phone Number:  
When / Why was your last veterinarian visit?
Current Pet #4    
Pet Name:    
Breed: Age:
Gender: Spayed/Neutered?
How long have you had this pet?
Where did you acquire this pet?
Obedience trained?    
On Heartworm Preventative? If yes, what kind?
Where does this pet spend the daytime hours?
  Evening Hours:
Where does this pet sleep?
Name of Vet where records for this pet can be obtained:
  Vet Phone Number:  
When / Why was your last veterinarian visit?
Current Pet #5    
Pet Name:    
Breed: Age:
Gender: Spayed/Neutered?
How long have you had this pet?
Where did you acquire this pet?
Obedience trained?    
On Heartworm Preventative? If yes, what kind?
Where does this pet spend the daytime hours?
  Evening Hours:
Where does this pet sleep?
Name of Vet where records for this pet can be obtained:
  Vet Phone Number:  
When / Why was your last veterinarian visit?
       
       
       
SECTION 5 – PREVIOUS PET INFORMATION (up to 10 years prior)
Prior Pet #1    
Pet Name:    
Breed: Age:
Gender: Spayed/Neutered?
How long have you had this pet?
Where did you acquire this pet?
Obedience trained?    
On Heartworm Preventative? If yes, what kind?
Where does this pet spend the daytime hours?
  Evening Hours:
Where does this pet sleep?
Name of Vet where records for this pet can be obtained:
  Vet Phone Number:  
When / Why was your last veterinarian visit?
Prior Pet #2    
Pet Name:    
Breed: Age:
Gender: Spayed/Neutered?
How long have you had this pet?
Where did you acquire this pet?
Obedience trained?    
On Heartworm Preventative? If yes, what kind?
Where does this pet spend the daytime hours?
  Evening Hours:
Where does this pet sleep?
Name of Vet where records for this pet can be obtained:
  Vet Phone Number:  
When / Why was your last veterinarian visit?
Prior Pet #3    
Pet Name:    
Breed: Age:
Gender: Spayed/Neutered?
How long have you had this pet?
Where did you acquire this pet?
Obedience trained?    
On Heartworm Preventative? If yes, what kind?
Where does this pet spend the daytime hours?
  Evening Hours:
Where does this pet sleep?
Name of Vet where records for this pet can be obtained:
  Vet Phone Number:  
When / Why was your last veterinarian visit?
       
       
SECTION 6 - PERSONAL REFERENCES
Preferably these should be people who know you and your lifestyle, have been in your home, and have seen your interaction with animals. Please have three refrences with Name, Phone Number, Relationship, and Amount of time you have known each other:
       
       
SECTION 7 - DISCLOSURES

Please note we are not looking to “get rid of” our fosters. We are looking for the best possible home for each and every one of our furbabies, so while you might provide a good and loving home for one, the foster parent might find another application that fits the needs of that particular pup better. There will most likely be another pup that will fit into your home. The yorkies are evaluated and their needs assessed before we make any attempt to place them. 

I understand I am not guaranteed a pup by filling out an application.  I certify that the information provided on this application is true and correct.
       
Applicant Signature: Date:
Co-Applicant Signature: Date: