CRVA Adoption Application
* Have you ever been owned by a Chesapeake Bay Retriever?
Yes No
* Please enter your name and address:
* Please enter your phone numbers:
* Number of adults in household and number & age of children:
* Do you own or rent your home.... and it's setting:
rural
suburban
urban
own
rent
landlord's permission?
* Type & dimensions of fencing:
* Why adopt a Chesapeake Bay Retriever?
breeding
hunting
companionship
protection
other
* To determine the hours the dog will be left alone daily, please
describe work schedules of adults in household.
* Where will dog spend days? Please be specific.
* Where will dog spend nights? Please be specific.
* Do you have other pets? Please list their species, sex, age,
and whether or not they are spayed/neutered.
* How will dog be exercised?
walking
swimming
retrieving
running
hiking
hunting
agility
other
What problems would deter you from adopting a specific chessie?
barking
jumping up
shedding
submissive urinating
climbing furniture
housebreaking
chewing
digging
heartworm positive
hip problems
eye promblems
other health concerns
other behavior concerns
What sex, color and age are you looking to adopt?
male
female
deadgrass
sedge
brown
0-2
2-4
4-6
6-8
any age
* Are you willing to have a rescue volunteer visit with you and
your family?
Yes No
* Are you willing to pay an adoption fee?
Yes No
Is there a particular dog you are already interested in?
* Please provide us with 3 references:
* Your Email Address:
* Indicates Response Required


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