Adoption Application Form

How are volunteers rescueing puppies?

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Your help is desperately needed! Won't you please give us a hand with our latest rescued Yorkies?

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We are always looking for people who would be interested in being a 'Sponsor' to one or more of our Forever Ours Yorkies! As a sponsor you will become a cherished person in this dog's life.

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We believe in going above and beyond to give every yorkie the care and kindness they deserve.

Fill the form

PLEASE NOTE: DUE TO HIGH VOLUMES OF APPLICATIONS, YOU WILL ONLY BE CONTACTED BY OUR ORGANIZATION IF WE BELIEVE YOU ARE A PERFECT FIT.

First Name:

Last Name:

Street Address:

City:

Postal Code:

Phone Number:

Secondary Number:

Email Address:

Please list the number of people in your household, their ages, and your relationship to them (please include your age as well!):

Do you own or rent your home? Own Rent

If you are not the homeowner, please provide the name and phone number where we can reach the homeowner/landlord:

What style of dwelling is your home?

How long will the dog spend alone on a daily basis?

Where will the dog sleep?

Have you adopted a rescue dog in the past? If so, where did you get the dog from?

Please list and describe all of your current pets (name, breed, age, sex, size, how long you have lived with them):

Please list your previous pets and what happened to them:

If you currently have dogs, how would you characterize their temperament toward other dogs?

If you currently have dogs, how would you characterize their temperament toward people?

Do you plan to use a crate for training? Why or why not?

What would you do if your dog had separation anxiety?

How do you plan on training your dog if they misbehave?

How and how frequently do you plan to exercise your dog?

Are you willing to housetrain a dog? Yes No

How important is the level of barking that the dog displays?

How important is it that the dog likes car rides?

What circumstances would cause you to return the dog to PSBR?

Explain why your experience/environment is the right fit for this specific dog (please read their bio carefully, PSBR will note their particular needs).

Veterinarian Info

NOTE: PSBR may contact your veterinarian during the application process. Please ensure that they are notified of a possible reference call.

I agree to notify my veterinarian of a possible reference call from Pomeranian and Small Breed Rescue.

Veterinarian's Name:

Clinic Name:

Veterinarian's Address:

Veterinarian's Phone Number:

What name are your pets listed under at the clinic? (e.g., your name, maiden name, spouse's name, etc.)

Personal Reference #1 (no family members)

First Name:

Last Name:

Home Phone Number:

Cell/Alternate Number:

Best Time to Call:

Relationship to Applicant:

Personal Reference #2 (no family members)

First Name:

Last Name:

Home Phone Number:

Cell/Alternate Number:

Best Time to Call:

Relationship to Applicant:

Yorkie Information

Select a Yorkie to adopt:

Adoption Fee

By clicking, I agree to pay the fixed adoption fee + $250 transportation fee (per Yorkie) to retain the Yorkie(s). If approved, I will receive an email and must pay immediately upon approval.

Select Payment Method

Agreement

By clicking the Submit button, I, the adopter, attest that to the best of my knowledge the above information is accurate and complete. I understand that falsely providing information can mean that my application will be terminated. Sending this application constitutes an electronic signature.

Adoption Application Form

How are volunteers rescueing puppies?

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Fill the form

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