Adoption Application

Your new best friend is waiting for you.

Adoption ApplicationCate Martin2024-05-30T19:20:40-04:00

Adoption Application Process

Please be detailed when filling out the application. The more we know the faster it is to place a dog with you. Incomplete applications will not be considered.
We try to reply to every application but it’s not always possible. If you don’t hear from us within 7 business days, please send us an email. If you no longer see the dog you are interested in on our website, that dog has been adopted.
We will keep your application on file for 6 months. Send us an email if you see another dog you are interested in meeting.

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General Information

Todays Date *

Name of Dog Desired *

Type of Dog Desired *

Age of Dog Desired *

Max Weight of Adult Dog Desired *

How did you hear about our rescue? *

APPLICANT INFORMATION

First and Last Name *

Street Address *

City *

State *

Postal Code *

Phone Number *

Can we text you? *

Yes

Email *

When is the best time to contact you? *

Your Age *

Applicant Employment Status *

Employer Name *

Job Title *

How long have you been at your current job? *

Is there a Co-Applicant? *

Yes

Co-Applicant Full Name *

Co-Applicant Phone Number *

Co-Applicant Email *

Co-Applicant Age *

Relationship to Applicant *

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FAMILY INFORMATION

Is everyone in your household in agreement to adopt a pet? *

Yes

Does your family have time to provide adequate training and exercise for this pet?

Yes

Please describe how you will exercise your pet. *

Are you willing to provide obedience training for your new pet and do you have a trainer in mind? *

Are you committed to caring for this pet for the duration of their life? *

Yes

Please list names, relationship and ages of all persons living in your home. *

How many hours per day will the pet be left unattended? Where will the pet stay while left alone?

Does anyone in your home have pet allergies? *

Yes

Who will be the pets primary caregiver? *

Who will be the pets financial responsibility? *

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PET INFORMATION

List all pets currently living in your home. Include name, species, breed, sex and age. *

List any past pets including name, species, breed, sex, and age at separation. *

Have you ever surrendered or rehomed a pet? If so, what were the circumstances? *

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VETERINARIAN INFORMATION

Do you have a current veterinarian? *

Yes

Veterinarian Name *

Veterinarian Phone Number *

Owner name on account *

List names and phone numbers of any additional or past veterinarians. *

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PERSONAL REFERENCES

Please provide two personal references.

Personal Reference Name 1 *

Relationship *

Email *

Personal Reference Name 2 *

Relationship *

Email *

Any additional information you would like to share that may help in approving your application? *

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Your application has been submitted and we will do our best to get back to you within 7 business days. Please be patient as we are a volunteer run rescue. Thank you!

There was an error trying to send your application. Please try again later.

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Our Mission

Dedicated volunteers who rescue and rehome animals in crisis and promote the humane treatment of homeless dogs through education and advocacy.

Yellow Brick Road Dog Rescue is a registered 501(c)(3) nonprofit organization. EIN# 99-1927475.

Located in Charlotte, NC.

Stay Connected

Mailing Address

P.O. Box 5362
Charlotte, NC 28299

Email: yellowbrickroadrescue@gmail.com

Before You Go

Will you consider a donation?
Your support will help create change and inspire hope with our rescue dogs.

YES! I will make a donation