What type of dog are you applying for?
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Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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-
Area Code
Phone Number
Secondary Phone Number
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Area Code
Phone Number
Have you adopted from YGRR before?
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Yes
No
How did you learn about YGRR?
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Back
Next
Do you have any household dogs? (Name, Breed, Age, Neutered/Spayed)
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Do you have any household cats? (Ages, Claws)
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Do you have any other animals? (Types, Ages)
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Please list all the names and ages of human household members (including yourself).
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Will your rescue dog come into contact with any children under the age of ten?
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Yes
No
Does any member of your family have allergies to animals?
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Yes
No
Is any member of your household physically challenged?
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Yes
No
How do your present dogs get along with other dogs?
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Are you willing to use baby gates or a crate?
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Yes
No
Are you willing to take your rescue dog to obedience training class?
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Yes
No
How will you exercise your rescue dog?
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How many hours will your rescue dog be alone (without humans) daily?
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Have you ever owned a dog for whom you were the primary caretaker?
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Yes
No
Do you have a veterinarian?
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Yes
No
Please specify the veterinarian's practice or name.
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Veterinarian Phone Number
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Area Code
Phone Number
Veterinarian Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
If you do not have a veterinarian, please provide the name and telephone of a personal reference:
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First Name
Last Name
Reference Phone Number
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-
Area Code
Phone Number
Back
Next
Why do you want to adopt a rescue dog?
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Why do you think you would be a good adopter for a rescue dog?
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Is your dwelling a...
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Do you rent, own or are you bound by an HOA agreement? (If you rent, a letter from your landlord allowing a medium or large dog must be provided. If you are bound by an HOA agreement, a copy of the existing pet policy is required).
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Do you have a fenced in yard? (Fences are required for most adoptions.)
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What type of fencing is it?
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Chain link
Wooden
Stockade
Wire
Invisible / Electric fence
Other
Do you currently use your invisible/E-fence?
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Do you have a pool?
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Yes
No
Does your pool have stairs and an elephant proof cover?
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Yes
No
Do you have a second dwelling?
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Yes
No
Back
Next
What age do you prefer? (Please note that we rarely have puppies)
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Up to 6 months
6 months to 2 years
2 years to 5 years
5 years to 7 years
7 years and over
Do you have any gender preferences?
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Will you consider adopting a special needs rescue dog that requires medication for a permanent but controlled condition?
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Yes
No
Submit
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