September 8, 2010
Login
Web
Site
Home
About Us
Adoptable Dogs
Adoption Application
Contact Us
Past Adoptions
2004 - 2006
2007
2008
2009 - 2010
Adoption Application
Adoption Application Considerations
Adoption Application
ADOPTION APPLICATION
Date Of Application Submission:*
First Name*
Last Name*
Street Address*
City*
State/Province*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip/Postal Code*
Work Telephone
Home Phone*
Cell Phone
Email
Occupation
Number Of Children Living At Home*
none
1
2
3
4
5
> 5
Ages Of Children
List all other dogs and/or cats in the household (include breed, ages and gender):
Are your dogs and/or cats, spayed or neutered?
yes
no
Please list any pets you have other than dogs or cats:
Please tell us about former dog(s), you have owned, if any. Describe your life with your former dog(s) and how you came to part with your former dog(s):*
Do you have a fenced yard?*
no
yes
If not a fenced yard, what arrangements will you have for the dog's exercise and toileting?
Will anyone be home with the Chinese Crested during the day?*
yes
no
How many hours on average will the Chinese Crested spend alone at your home?*
1
2
2
3
3
4
5
6
>7
Where will the dog sleep?*
crate
floor bed
our bed
laundry room
dog house (outside)
seperate room
couch
Your veterinarian's name:
Vet phone number:
How long have you used this vet?
New
1 - 2 years
2 - 4 years
> 4 years
Is your financial status stable enough to support the dog for its lifetime?*
yes
no
Please tell us anything about you and/or your family that help us get to know you better:*
INFORMATION ABOUT THE DOG YOU ARE SEEKING
Gender*
male
female
no preference
Variety*
Hairless
Powder Puff
No Preference
Age Of Dog*
No Preference
Puppy
Young Adult
Adult
Senior
Color Preference
yes
no
List Color Preferences
Generally speaking, what kind of temperament are you looking for in a dog?*
What specifically attracts you to the Chinese Crested breed?*
Describe the relationship you plan to have with the Chinese Crested:*
What are your expectations and/or concerns about adopting a Chinese Crested from Rocky Mountain Chinese Crested Rescue?*
Comments:
Do you have knowledge of grooming and skin maintenance specific to Chinese Cresteds?*
yes
no
Would you consider adopting a "special needs" rescue, i.e. a Chinese crested with medical problems or challenges?
yes
no
Comments
Would you be interested in adopting a Chinese Crested from outside of Colorado? Note: This may involve paying for the dog's transportation, flight, health certificate, crate, etc., in addition to the adoption fee.
yes
no
Comments:
Would you consider "fostering" a Chinese Crested, if the need arises?
yes
no
Comments
I agree to allowing a member of Rocky Mountain Chinese Crested Rescue to conduct a sscheduled home visit prior to my being approved to adopt from the Rescue.*
yes
no
Comments
PERSONAL REFERENCES: (Please use a reference other than immediate family):
First Name*
Last Name*
Street Address
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip/Postal Code
Home Phone*
Work Phone
Cell Phone
Your relationship to your personal reference:*
Please type your name here, as signature confirmation that you have completed this application with all seriousness and honesty. We thank you!*
Enter the code shown above
Submit
* Required
Home
|
About Us
|
Adoptable Dogs
|
Adoption Application
|
Contact Us
Copyright 2009 Rose Consulting, PC
Terms Of Use
Privacy Statement