Chesapeake Bay Retriever Adoption Application

AMERICAN CHESAPEAKE CLUB, INC. RESCUE NETWORK

CHESAPEAKE BAY RETRIEVER ADOPTION APPLICATION

Name:
Street Address:
City:	State:	Zip:
Phone (home):	Phone (work):
E-mail:

Why are you interested in adopting a Chesapeake Bay Retriever?

You want to acquire a Chesapeake as a:

Hunting Dog
Pet
House Dog

Indoor
Outdoor
Indoor/Outdoor

List any other use you would have for a Chesapeake:

Have you previously owned a Chesapeake?

Yes

Family Information:

Marital Status:

If married, is spouse in agreement about adopting a Chesapeake Bay Retriever?

Yes

Any children?

Yes

Ages

Other household members who will have contact with the dog?

Do you own other dogs? (specify)

Yes

Ages

Cats?

Yes

Is someone at home during the day?

Yes

How many hours per day would dog be alone?

Do you have a fenced yard?

Yes

Size
Height

Do you have a kennel run?

Yes

Size
Height

Do you want to adopt a

Male Female (adoption Chesapeakes must bespayed or neutered)

Age range you are willing to adopt:

How long are you willing to wait for a Chesapeake?

If you have not owned a Chesapeake before, what qualities do you hope to find in the one you adopt?

Do you describe your lifestyle as:

Very active/outdoors activities

Quiet/ less active

Do you understand that Chesapeakes are quite active dogs and, although they are good indoor companions, they are a breed with moderate to high exercise requirements?

Yes No

If not a previous Chesapeake owner, have you read any books on the breed?

Yes No

Are you willing to attend obedience classes with a Chesapeake?

Yes No

I have answered the above questions truthfully and to the best of my knowledge:

Yes No

We appreciate your interest in adopting a Chesapeake Bay Retriever. Please feel free to provide any additional information you would like us to consider in placing one of our Chesapeakes with you. Feel free to give us some insight into the expectations you have for this new addition to your family.