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Online Adoption Application/Home Form

List Your Home

This form will allow you to post your family description and desired features in a rescue dog on the Chesapeake Bay Retriever Relief & Rescue pages. Please inform us as soon as you adopt a dog so that we can remove your listing. Additionally, your listing will be forwarded to a private mailing list of Chesapeake Bay Retriever rescuers.

Please fill out this form as completely as possible. The more information that you can provide us, the better we can match your needs with the right dog. Please check all boxes that apply where appropriate. Also, don't forget to check the listings of Rescue Dogs or the Adoption Options Website to see if any of the current dogs would be an appropriate match. When you have found a dog or are no longer interested in adopting one, please contact us so we can remove you from our list.

Please Note - These pages are not to be used to seek out a CBR for purchase. This is for the placement of rescued Chesapeake Bay Retrievers only.

Your Name
Your Address
City
State
Zip
Phone number
Email address
Number of family members in the household:
Number of children :  
Ages of the children (separate by commas)
Household setting Rural   
Suburban   
Urban
Dwelling type House
Apartment
Townhouse
Other
Do you Rent   Own
If you rent, do you have the landlord's permission to keep a dog? Yes   No
Do you have a fenced-in yard? Yes    No
Height of fence: 
Type of fencing: 
Do you have any other animals?
Dogs (number)  
Breed(s):
Gender(s):
 
Cats (number) 
 
Birds (number)
Other (specify)
Is someone home during the day? Yes    No    Sometimes
Are you planning to move in the near future? Yes   No

Desired Dog Characteristics
What color dog do you prefer?
Would you be willing to accept another color? Yes   No
Which sex do you prefer? Male   Female   Doesn't matter
What age range(s) would you be willing to accept?
Puppy (less than 6 months)
6 months - 1 year
1 - 2 years
2 - 3 years
3 - 5 years
5 - 10 years
Over 10 years
Doesn't matter

Other Important Information
Do you intend to keep the dog primarily indoors or outdoors? Indoors  Outdoors  Both
Have you ever owned a Chesapeake Bay Retriever before?
Yes     No     If yes, how many?
Would you be willing to have a rescue representative visit you in your home (if you decline, you will be disqualified unless you mail us a letter of recommendation from your veterinarian)?
Yes    No
Are you willing to pay a rescue fee? Yes    No
Are you willing to pay for other special costs, such as transportation, medical expenses, crates, etc.?  Yes    No
For what purpose(s) do you wish to adopt this dog?
Companionship
Agility
Obedience
Search and Rescue
Assistance Dog
Hunting
Other (specify)
Why do you want to adopt a Chessie rather than another breed of dog?
Other Comments:


Please send all corrections or comments about this website to webmaster@cbrrescue.org.