This application is the first step in the adoption process for one of our fosters. All of this information is important so please be as accurate as possible. Also make sure EACH question has an answer even if it is  N/A, IT IS IMPORTANT FOR DELIVERY OF THE APPLICATION THAT EACH AND EVERY SPACE HAVE AN ANSWER OR N/A.You will receive an email or phone call if your application is chosen for the dog you are applying for. We may receive several applications for the same dog and our job is to choose the best match for that particular dog.  We only adopt in the state of Florida and do not deliver you must be willing to pick up your dog. To be sure your application gets to the right foster mom make sure you put a name or two of the dogs you are interested in.

Read the following carefully 
I declare that the information I have provided in this application is complete and correct. I further declare that I am financially and physically able to care for a rescued dog. I understand that proper food and veterinarian care may be costly, and I am able and willing to meet the needs of my adoptive dog. 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, All Yorkies Rescue reserves the right to either refuse adoption or to nullify the adoption and reclaim said adopted dog from my premises without reimbursement of the adoption donation. I release All Yorkies Rescue from any liabilities I may incur from the adoption process. 
The Litter
Request to Surrender 
adoptables page 2

Your Name:
Street Address:
Zip Code:
Home Phone Number:
Cell Phone Number:
Email Address:
How long have you been at your current address:
Previous address if less than 2 years:
How long were you at your previous address:

Best time to reach you at home:
Please select the term(s) that best describe your current living situation:
Will you accept a collect call:
Work Phone:
Best time to reach you at work:
Spouse/partner's name:
Spouse/partner's age:
Date of last vet visit for each pet:
Spouse/partner's employer:
Spouse/partner's occupation:
Spouse/partner's work phone:
Number of children living in your home:
Age and relationship of the children:
Do you have young children visit:
Adoption and care Information. Must be completed in it's entirety.
This data is very important to us.  Please be specific.
Age and relationship of the children:
Backyard fenced:
Please list everyone in your home not mentioned above.  Their ages and relationship to you.
If not, who and why not:
Home Ownership:
Landlords Name:
Landlords Phone Number:
Social Environment:
Does your home have a backyard:
Living Environment.  Must be completed in it's entirety.
Fence type:
Please PRINT this page before submitting.
Fence height:
Is fence permanent:
Is the edge of the fence buried to prevent tunneling:
If needed can the gate be padlocked:
Do you have a pool or pond:
Is so, please describe precautions taken to keep the pets from drowning danger:
Why do you want to adopt:
Is everyone in your home agreeable to adopting:
If the above dog is not available, do you have a second choice:
Is there a specific dog you are interested in:
Preference of male or female:
Will you attend obedience training:
Trainers name:
Specifically what will the pets living situation be:
Do you have an age preference:
Will your adopted dog be left alone:
If YES, for how long:
Under what circumstances would you give up this pet:
What activities will you engage in with your new pet:
Have you ever owned a dog:
If so, where is the dog now:
Do you have other pets:
Please list age, sex and species:
Are all pet(s) current 
on vaccinations:
Are all pet(s) spayed/neutered:
If not to either, which pet(s) and why:
Are all pet(s) on heartworm preventative:
Name of person pet(s) vet files are under:
If not please explain:
Have any of your current pets shown aggression or bitten:.
If YES, please explain situation:
Please list all pets not listed above that you have owned in the past 10 yrs, and where they are now:
Do you understand that often times the complete history of a rescue may not be known:
Will you be willing to work with us to correct any possible behavior problems:
Vet name, address, phone number and fax number:
Groomer name, address and phone number:
Please provide the name, address and phone number for 3 references:
Reference 1:
Reference 2:
Reference 3:
What behavioral problems are you not willing to handle:
Your age:
Modular Home