You may also Copy & Paste this version of the application into an e-mail & send.
Remember to save the info on this application. If you exit before finishing it will not be saved.
NOTE: COMPLETING THE APPLICATION DOES NOT GUARANTEE APPROVAL FOR ADOPTION
Please Complete ALL of the Following Questions
1-Name of dog you are interested in:
2-Preference of any dog you are interested in:
(i.e., Age, Gender, Hair Type, Activity Level etc.)
Why are you interested in getting a dog?(companionship, service dog, working breed etc):
3-Your Full Name ( First Middle & Last):
4-Your Current and Previous 3 years Address) :
5-Cell Phone: 6-Home Phone:
7-How long have you lived here:
8-Do you own or rent this property?
9-If Renting please provide Landlord contact information
for approval of this breed and size dog to live with you.
10-Employer name and address and phone;
11-Names and date of birth of ALL of the persons living in your home.
Do you have Frequent visitors i.e. Grandchildren/neighbors.
Approximate Ages of frequent visitors:
12-Do you have a yard?
13-Is your yard fenced?
14-If fenced, it is COMPLETELY fenced on all sides, What is the fence height and material please:
15-Have you owned a dog before? What breed(s)?
16-What do you like most and least about having a dog?
17-Do you have other animals living with you now ? And where are they kept?
18-Do you or any of your family members have animal allergies?
19-Have you ever had to give up an animal?
When and Why?
20-How many hours per day are you gone?
Will the dog be left alone?
21-Will you be using a crate or closing off an area to keep the dog contained while you are gone?
22-What is your household activity level? (lots of company, kids events, etc: or low key, quiet)
23-How often do you travel?
24-Do you have someone to care for the dog if you do travel?
Is this someone you can trust to take the dog if something happens to you?
25-If so, please provide that person's contact information as a personal reference.
(you may use an email address if you wish)
26-Please provide current or previous veterinarian contact information.
27-Can you afford to care for a dog? (please consider any vet bills, food, grooming, boarding etc)
28-There is an adoption donation fee of $275.00 dollars. When accepting the dog do you
understand that you would agree to pay this?
29-We encourage all new adoptee's to attend training classes (even if you have owned dogs
before). Are you wiling to do this?
30-Home visits are done prior to adoption and after. Would you object to this?
31-How did you hear of Yellow Brick Road Rescue?
32-Do you understand that completing this form does not guarantee approval for adoption?
33-If accepted for adoption, you will be required to sign an adoption contract agreeing
to specific conditions ((i.e. allowing Yellow Brick Road to visit your home after the adoption,
understanding there are penalties to violating contract agreement etc.) Are you willing to
sign the agreement?
34-Have you contacted your home owners insurance regarding the purchase of this dog?
THANK YOU SO MUCH FOR TAKING THE TIME TO COMPLETE THIS FORM!
We will get back to you ASAP! Please understand that this can be a bit time
consuming. Your patience is truly appreciated. If you do not hear back in 3 days,
feel free to send an e-mail to check on the status of your application : )
Please Send Completed Adoption Application to Dana at the link below.