LYR Adoption/Foster Application

Which Dog are you interested in Fostering? (Name/'s)

First & Second Choices

If unavailable what would your Foster Preference be? (Check all that apply)

Check each option that you are interested in.

Are you willing to work with us to correct any possible behavior issues that the rescue may have?

Do you have a trainer that you would use if needed? Yes / No (If Yes / Provide Information)

Name

First NameLast Name

Date of Birth?

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState

Zip Code

Work Phone;

Area CodePhone Number

Contact Number

Area CodePhone Number

Please fill out the entire application. All questions marked with a ( * ) are required and they must be answered. If they are not, the application will not submit. If any of those marked required do not pertain to you, mark (N/A) in order to move forward with the application process.

List the Names & Ages of any additional (Adult) family members or those who live in your home.

List the Names & Ages and Relationship to you of any Children under the age of #18 who live with you or who visit your home on a regular basis.

List the Employers, Occupations & Hours of Everyone who lives in your home?

Do you Own or Rent your home?

Choose which best describes your living situation.

If a Rental, does your lease permit you to have animals?

If living in an apartment / condo are there any restrictions on dog ownership or Breed? (Explain)

Landlords Name;

First NameLast Name

Landlord's Phone #

Area CodePhone Number

Do you have a yard with a fenced in yard?

If Yes, Please describe in detail including the Type & Height of fence and any Security measures taken to prevent animals from escaping or being harmed by predictors.

Please be specific with your description.

IF No, Please describe how you plan to exercise the rescue ?

How many hours per day will your Rescue be left alone?

Please describe in Detail what the Rescues living situation will be. (Please give a detailed description including hours when no one will be home.)

Please be very Specific with your answer .

Have you had rescues previously?

If Yes, name, ages, breed? Describe: Where you got them, where they are now and if re homed why?

Please be specific

Other animals living in your home? (Click all that apply)

Are your pets currently UTD on Vaccinations?

Are your pets on Heart-worm Preventative?

Are your pets Spayed or Neutered?

List ALL family Pets/ Include the Following: (Type / Breed / Age / Dates of last Vet. appointment & Vaccinations, Heart-worm, Flea meds. & Spay/Neuter dates)

Have any of your pets Ever displayed any Food or other aggression's toward other animals or humans?

If so, Please give a detailed description. (Include: Date of any bite incidents)

List all Previous pets that you've owned in the past 5 yrs. (Include: Years owned & where they are now.

Name & Address of Current Vet

Name

Street Address Line

CityState

Zip Code

Phone Number

Area CodePhone Number

Name & Address of Previous Vet

Name

Street Address Line

CityState

Zip Code

Phone Number

Area CodePhone Number

Provide 3 personal References including at least 1 person who lives with you. (Include: How they know you).

By signing via electronicly I agree that the information that I have provided in this application is complete and correct. I understand that any false information I have provided will invalidate this and any future applications. I further declare that I am financially and physically able to care for a rescue animal. I understand that proper food and veterinarian care may be costly, and I am able and willing to meet the needs of my rescue animal. I understand and agree to get yearly dog tags and provide Little Yorkie Rescue with verifiction includilng the assigned number. I understand the requirements and grant permission for Home Checks at random, both prior to and following adoption. I submit that if a Home Check reveals falsification or misrepresentation of any facts on my part, Little Yorkie Rescue reserves the right to either refuse adoption or to nullify the adoption and reclaim said rescue from my premises without reimbursement of the adoption fees. I release Little Yorkie Rescue from any liabilities I may incur from the adoption process or by the rescue while in my care.

Please sign below:

Type your full name as entered above

Date

Foster Application

Fosters Personal Information

Yourself & Family

Home Environment

Foster Dogs Living Space & Care

Current & Previous Pets

Vets & Personal References

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