Yankee Chihuahua Rescue and Adoption, Inc (YCR)

Application for Adoption

Only residents of Connecticut, Rhode Island, Maine, Massachusetts, New Hampshire, and Vermont
can be considered for adoption of Yankee Chihuahua dogs. Please answer and fill in all questions. Missing information and incomplete applications will not be considered.

You may submit an application by;

1) Completing the application below and it will automatically be forwarded to us;

2) Copy the form at; Google Documents and Email it to;
adopt@YankeeChihuahuaRescue.org

3) To have an Adoption Application emailed to you please send an email to;
adopt.application@YankeeChihuahuaRescue.org

If you can not complete the application or have questions, Please Email; adopt@YankeeChihuahuaRescue.org






*State

Please note; We can not place dogs outside of these areas. Contact Chihuahua Rescue and Transport (CRT) for information about adoption in your area.










**
Yes, everyone in the household knows I am applying for a Yankee Chihuahua.

** Does every member of your household want a dog


**Does anyone in the household have allergies


** Please describe those pets that are currently with you (type, age, sex, altered status)


**Have you ever owned a dog before? How many dogs have you owned in the past 10 years?


** Have you ever owned a Chihuahua before?


* *What made you choose a Chihuahua - Chihuahua/mix?


**Please describe those pets that are no longer with you and why


** List all adults in household, including yourself, their ages and relationship to applicant.
(Please include non-related residents and housemates)


** List all Children in household and their ages, if none please note so.


** Who will be responsible for feeding, housebreaking /training?


**Do you own or rent your residence?


If you rent, please provide the name, address and phone number of your landlord.

Please note: if you live in a condo, assisted care facility or senior housing,
we will need a letter from management stating you may adopt a dog from us.

**What type of home do you live in? (Condo, single family dwelling, apartment, etc.?)


** Where do you plan on having the dog sleep every night?


** How much time will you be able to spend outside with the dog?


**How many hours a day will the dog be left unattended? and where will they stay?


**How frequently will you be gone away from home on business/ vacation/trips?


**When you are on vacation where will the dog be kept?


**What do you intend to feed the dog?


**How will you house train the dog (details please)?


**Are you familiar with Crate Training? We encourage all Foster Parents to Crate Train, it helps the foster adapt more quickly and with less stress when they find their forever homes


Please list any preference you have in adopting a dog (age sex personality).
If you have seen a dog at our web site that interests you, this would be the place to include that dogs name.

Age; Up to 6 years 6 years or older No Preference
Sex; Male Female No Preference
Size; Up to 6 lbs Up to 10 lbs Over 10 lbs No Preference
Please consider me for an adoption of a Special Needs Dog
Please consider me for an adoption of a Senior Dog
Please list any other specifics that would help us match a Chihuahua:


**Do you understand that YCR requires this dog to be spayed or neutered, and will not place dogs in households with intact dogs? Chihuahuas in households with intact dogs. Please note: if you are looking for an unaltered pet, YCR will not be able to place a Chihuahua with you.
All adult Chihuahuas are altered prior to placement.
All Puppies are required to be spayed or neutered at the adopters expense and a YCR Spay /Neuter Contract and Paid in Full Receipt from their veterinarian.

**Will you keep the dog licensed, and have an ID (other than the license) on the dog at all times? , I under stand Yankee Chihuahua Rescue requires the dog be licensed and wear an ID at all times.

**Do you agree to contact YCR if you can no longer keep this dog? I agree to contact YCR if I can no longer keep this dog.

** Will you allow a representative of YCR visit your home? YCR can not adopt to homes without a Home Visit. I will allow a representative of YCR to visit my home

** Do you understand that if a rescue representative from out of state calls you, they may be calling collect? I understand that if a rescue representative from out of state calls me they may be calling collect.

**Do you understand that an adoption donation is requested for each Chihuahua?

I understand that an tax deductible donation is requested. I understand that my donation will help to provide medical care for every Yankee Chihuahua. Please note: The typical adoption donation for a healthy dog $375.

This donation helps defray the veterinary costs incurred for spay/neuter, immunizations, heart worm and fecal testing, microchip and other medical needs required by every Chihuahua placed by YCR, Inc.

**Please provide the name, address of the veterinarian you will be using for this dog.
We will need you permission to contact your Vet.

** Veterinarian Phone Number


Personal Reference: If you have a dog that attends Doggie Day Care or a Dog Walker please provide their information :
**Name

**Address

**Phone



I represent that the information that I have provided on this form is the truth to the best of my knowledge and belief and hereby give my permission for you to use any of the above information to confirm that all information provided is the truth. This means you give us your permission to call references and that you allow us to contact your vet and that you hereby give consent for your vet to release the information in your current/past pet's health files to us.
* Signature *
This is an Electronic Signature representing your acknowledgement everything above is true.

Where did you hear about us? Comments?


Incomplete applications can not be considered.     Incomplete application require time to follow up and all info is important.
When you have answered all the questions;
Submit Application:

 

To Reset the Application and start over:

You may submit an application by;

1) Completing the application below and it will automatically be forwarded to us;

2) Copy the form at; Google Documents and Email it to;
adopt@YankeeChihuahuaRescue.org

3) To have an Adoption Application emailed to you please send an email to;
adopt.application@YankeeChihuahuaRescue.org

If you can not complete the application or have questions, Please Email; adopt@YankeeChihuahuaRescue.org

(2011)
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