Colorado Japanese Chin Rescue
720-288-8436

Adoption Application

We require an adoption application on all dogs adopted from rescue. If you are interested in adopting one of our dogs, please fill out the Adoption Application below and a volunteer will get back to you as soon as possible. Thank you for considering a rescue dog!

Adoption Application
 
Which dog(s) are you interested in?:
Applicant's Full Name:
 Co-Applicant's Full Name:  
 Address:  
 Address 2:  
 City:  
 State:
 Zip Code:  
 Daytime Phone:  
 Evening Phone:  
 E-mail:  
 Age of Applicant:  
 What type of home?:
 Please list all children in the household and their ages:  
Do you rent or own your home?    RentOwn
 Do you have a fenced yard?:  
 If not, how do you plan on exercising your dog?:  
 What other kind of pets do you own?:  
 Are your pets spayed or neutered?:  
 How long are your pets left home alone each day?:  
 Where will the dog stay when you aren't home?:  
 Have you ever owned a Japanese Chin?:  
 Would you consider a chin with special needs?:  
 What are your expectations of a dog?:  
 What makes you a good pet owner?:  
 Under what circumstances would you give up your dog?:  
 Please list 3 references including names and phone numbers. Please no family members:  
 Please list your vet's name and phone number:  
 Anything else you would like to share with us?:  
Web Hosting Companies