Valerie's Earth's Angels
A Site dedicated to Earth's most wonderful dogs!
Adoption Application
About You & Your Home
Contact Information
Your Name: Email:

Your Address:

Landlord's Name:

I Ph#:
Home Ph#:
Work Ph#:
FAX Ph#:
Other #:
Yard: Fence:
You are: and have children, between: and years of age.
You want:   How did you find this site?

Are You Ready?
Yes No Are you willing or able to modify your daily schedule to accommodate a Yorkie's access to a fenced area or to walk a Yorkie on a leash to perform bodily functions at least 4 times during the day?
Yes No Are you aware of the importance of keeping aYorkshire Terrier on a leash when out of the house?
Yes No Are you aware that Yorkshire Terriers are house dogs. They can be kept outdoors for short time periods but CANNOT be chained, tied outdoors or left outdoors alone for long periods unsupervised.
Yes No Is there a local ordinance in your area pertaining to owning/housing and animal that would require licenses
Yes No Are you willing to give your Yorkie two weeks to a month to adjust?
Yes No Are you willing to keep a collar with a tag bearing you name, address, phone number on your pet?
Yes No If for any reason, you are unable to keep your Yorkie, will you agree to return him to me?
Yes No Are you willing and able to accept full care, costs, and necessary burdens for the life of a Yorkie?
Yes No Have you ever owned a Yorkshire Terrier?
Yes No Will someone be home during the day with your Yorkshire Terrier?
Yes No Have you ever sold, given away, or sent a pet to a shelter?
Yes No Would you consider using a doggie door to allow your Yorkshire Terrier access to a potty area?

In addition to regular life at home would your Yorkie:
Yes No Walk Routinely with a family member? Yes No Go to obedience classes?
Yes No Go to work with you? Yes No Travel with you?
Yes No Be a playmate for your children / other pets?

Match your Yorkie and you
Why do you want to live with a Yorkshire Terrier?
List all pets you have owned in the past 10 yrs.:
List current pets, sex, age, vaccinations, & if altered:
Tell us about any pet sold, given away
or sent to a shelter:
How many hours a day will your Yorkie be alone?
Where will your Yorkie be kept when alone?
Where will your Yorkie be kept when you are home?
Where will your Yorkie sleep at night?
What are your feelings about allowing your
Yorkie on furniture:
Who will be responsible for feeding,
grooming, & training your Yorkie?
What personality traits are important to you in your Yorkie?
What personality traits would you NOT want in your Yorkie?
How would you describe your household activity level:
Estimate how many times per month children may visit:
Would you accept a dog with a minor health problem?Yes No
Will you work with your Yorkie if is is not quite housetrained?Yes No
Are you familiar with crate training as a housetraining method?Yes No
Are you interested in learning about crate training?Yes No
Most yorkies need to be professionally groomed regularly.
($20-$50 is not unusual) Are you willing to do this?
Yes No
Would you consider putting a pet down if you were unable
to afford veterinary care?
Yes No
Are you or your spouse in the military?Yes No
If yes to above check all that apply Active Duty    Reservist    Guard   
Retired    Air Force    Army   
Marines    Navy   
Would you give up your pets if travel or move occurred?Yes No
What size Yorkie do you want as an adult?
Any comments you would like to make: