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Email Address:
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Date Submitted
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Full Name
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Street address
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City, State & Zip Code
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How often do you read your emails?
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Once a day
Once a week
Twice a week
Once a month
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Work Phone
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Best time to call:
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Home Phone
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Best time to call:
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Fax Number
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Accept Collect Calls?
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Yes
No
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Date of Birth *Must be at least 21 years of age to adopt*
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Occupation
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Do you live in a
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House
Apartment/Condo
Mobile Home
Other
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Do you
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Own
Rent
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If yes to rent, does the landlord allow dogs?
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Yes
No
Not applicable
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Landlord's Phone (If you rent and do not supply the landlord's phone number, this application will not be screened)
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Do you have a fenced yard?
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Yes
No
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If no, what arrangements will you have the dog's exercise and toilet duties?
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WILL ADOPTING A CREST-CARE DOG PUT YOU OVER THE LIMIT OF PETS ALLOWED BY YOUR CITY OR TOWNSHIP?
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Is there a particular Crest-Care dog you are interested in adopting?
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Are you married or co-habitating with a significant other?
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Yes
No
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Does your partner/spouse know of and approve of the adoption?
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Yes
No
Not applicable
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Do you have children? If so, how many?
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What your the ages of your children?
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Are you or other household members allergic to dogs?
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Yes
No
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List all other dogs in the household (including breed, age, and sex)
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Do you breed? If so, what breed?
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How many litters per year?
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Are your dogs/cats spayed/neutered?
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Yes
No
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Vet's name
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Vet's street address
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Vet's City, State and Zip Code
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Vet's phone number
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How many hours on average will this dog spend alone at home?
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If you have had a dog before, describe the last dog you owned and what happened to it.
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Tell us anything else about your family you'd like us to know.
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Why are you interested in a Chinese Crested?
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Have you owned a toy breed before?
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Yes
No
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Have you owned a Chinese Crested before?
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Yes
No
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If no, are you willing to learn and not hesitate to call a Crest-Care memver with questions or concerns?
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Yes
No
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Are you familiar with the characteristics and temperament of the Chinese Crested?
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Yes
No
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Are you familiar with the grooming and maintenance of the Chinese Crested?
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Yes
No
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Are you committed to caring for this dog for its lifetime?
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Yes
No
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Do you consider yourself financially stable enough to provide proper diet and medical care for a Chinese Crested, including emergency treatment if necessary?
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Yes
No
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Are you aware that there is an adoption fee which will support future rescues of Chinese Cresteds?
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Yes
No
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How did you hear about Crest-Care?
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Which sex of dog are you interested in?
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Male
Female
No Preference
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Variety of Chinese Crested
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Hairless
Hairy Hairless
Powderpuff
No Preference
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Age preference?
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Puppy
Young adult
Adult
Senior
No Preference
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Would you consider a Crested with medical problems (special needs) or limitations?
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Yes
No
Depends upon condition
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Generally speaking, what kind of temperament are you looking for in a Chinese Crested?
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What qualities appeal to you about the Chinese Crested?
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Where will the Chinese Crested stay when it's alone?
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Where will the Chinese Crested sleep?
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Please tell us of any other expectations or concerns you may have.
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Would you be willing to assist a Chinese Crested in need for Crest-Care if the need arises?
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Yes
No
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Would you be interested in becoming a Representative for Crest-Care?
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Yes
No
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Please add any additional comments for consideration here.
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Personal Reference Name (please use a reference other than immediate family)
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Personal Reference Address
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Personal Reference City, State & Zip Code
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Personal Reference Phone Number
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Best time to call?
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I understand that a Crest-Care member will conduct a home visit prior to my being approved to adopt?
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Yes
No
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Would you be interested in adopting adopting a dog from another part of the country?
(This would involve paying for the dog's transportation (flight, health certificate, crate), in addition to adoption fee).
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Yes
No
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How far are you willing to travel to obtain a rescue approved for adoption?
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Due to the increasing cost of ground transportations, would you be willing to assist Crest-Care's representatives with gas costs associated with transporting your approved adopted dog from it's foster home to you?
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Yes
No
Dependent upon distance of transport
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Have you applied to adopt with Crest-Care previously?
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Yes
No
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If Crest-Care does not have a Chinese Crested in need suitable to your home, would you be willing to be referred to another rescue organization or private rescue of Chinese Cresteds?
Please note that referral does not mean that Crest-Care approves or endorses any organization/private rescue to whom we may refer you. Therefore, by checking yes, you are releasing Crest-Care, Inc. of any and all liability and/or responsibility if this application is referred to another grou or private rescue.
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Yes
No
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