Adoption Form – luxeyorkierescue

PLEASE NOTE: DUE TO HIGH VOLUMES OF APPLICATIONS, YOU WILL ONLY BE CONTACTED BY OUR ORGANIZATION IF WE BELIEVE YOU ARE A PERFECT FIT.

Name *

E-Mail *

Your Message

Text

Street Address: *

Postal Code:

Phone Number: *

Please list the number of people in your household, their ages, and your relationship to them (please include your age as well!):

Do you own or rent your home?OwnRent

If you are not the homeowner, please provide the name and phone number where we can reach the homeowner/landlord:

What style of dwelling is your home?

Where will the dog sleep?

Have you adopted a rescue dog in the past? If so, where did you get the dog from?

Please list and describe all of your current pets (name, breed, age, sex, size, how long you have lived with them):

If you currently have dogs, how would you characterize their temperament toward other dogs?

How do you plan on training your dog if they misbehave?

How and how frequently do you plan to exercise your pet?

Are you willing to housetrain a dog?YesNo

What circumstances would cause you to return the yorkie to us?

Explain why your experience/environment is the right fit for this specific dog (please read their bio carefully, PSBR will note their particular needs). *

Yorkie Information

Name of the Yorkie you wish to adopt

By clicking, I agree to pay the fixed adoption fee + $250 transportation fee (per Yorkie) to retain the Yorkie(s). If approved, I will receive an email and must pay immediately upon approval.Agree

Select Payment Method

Agreement

By clicking the Submit button, I, the adopter, attest that to the best of my knowledge the above information is accurate and complete. I understand that falsely providing information can mean that my application will be terminated. Sending this application constitutes an electronic signature.

PLEASE NOTE: DUE TO HIGH VOLUMES OF APPLICATIONS, YOU WILL ONLY BE CONTACTED BY OUR ORGANIZATION IF WE BELIEVE YOU ARE A PERFECT FIT.

Adoption Info

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