You are filling out an Adoption Application for Missy

Adoption Application

All information is important so please be as accurate as possible. All questions must be answered. If a question does not apply to your situation, type Not Applicable. Use the TAB key to move to the next question. Do not press the ENTER key. When you have completed all fields, read the conditions statements and type your name in the signature box. You can scroll back up through the form to make sure all boxes are filled. Then click SUBMIT at the bottom left portion of the screen. You should see a message indicating you have successfully submitted your application.


If after submitting you still see the form on your screen, you have missed one or more questions. Scroll through the form to find any red statements appearing above an empty box and fill in the empty box. Once you have successfully completed all boxes, type your name in the signature box at the bottom and clicked on SUBMIT. If you have continued difficulty with the online application, you may contact Carl Sullenberger for assistance with form completion. His email is: treasurer@uyr.us.

Personal information: (must be completed in it's entirety)
This data is very important to us. Please be as specific as possible.
This data is very important to us. Please be as specific as possible.
Living Environment (must be completed in it's entirety)




Adoption and Care Information (must be completed in it's entirety)



Current & Previous Pets
We will provide you with an evaluation of the foster Yorkshire Terrier's temperament based on the information provided to us by the surrendering owner or information provided by the shelter where the yorkie came from.
References
Please provide the name, address, and telephone number of three (3) references and their relationship to you.
Please only include one (1) family member.
Read the following carefully
I declare that the information 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 21 years of age or more and 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, United Yorkie Rescue reserves the right to either refuse adoption or to nullify the adoption and reclaim said dog from my premises without reimbursement of the adoption donation. I release United Yorkie Rescue from any liabilities I may incur from the adoption process.

All information is important so please be as accurate as possible. All questions must be answered. If a question does not apply to your situation, type Not Applicable. Use the TAB key to move to the next question. Do not press the ENTER key. When you have completed all fields, read the conditions statements and type your name in the signature box. You can scroll back up through the form to make sure all boxes are filled. Then click SUBMIT at the bottom left portion of the screen. You should see a message indicating you have successfully submitted your application.

If after submitting you still see the form on your screen, you have missed one or more questions. Scroll through the form to find any red statements appearing above an empty box and fill in the empty box. Once you have successfully completed all boxes, type your name in the signature box at the bottom and clicked on SUBMIT. If you have continued difficulty with the online application, you may contact the foster parent of the dog you are applying for and request they help you submit your application.