of Greater Denver

 Central Rockies Schipperke Club
   of Greater Denver
           
   
  CRSC Home
   
  What is a Schipperke?
   
  Health
   
  Our Club
   
  Specialty Dog Shows
   
  Pedigree Yearbooks
   
  Related links
   
  Member Login
   
   
   
   
 
Rescue Application Online
 
Name:   
Spouse's Name:   
Address:   
City:      State:     Zip: 
Home Phone:        Work Phone: 
E-Mail Address:   
Occupation: 
  
Spouse's Occupation: 
  
Ages of Children at home: 
  
Other animals in household: 
 
Dog breeds previously owned:    
If gone, what happened?  

Do you live in a house or an apartment?
If you rent, do you have your landlords permission to have a dog? Yes     No
Landlord's Name:        Phone: 
Do you have a securely fenced and gated yard? Yes     No
Where will the Schipperke spend the days? 
Where will the Schipperke spend the nights?
About how many hours will the schip be alone
each day?      each week?
About how many weekly visitors do you have to your home?
Does everyone in the household want to adopt this dog? Yes     No
Do you understand that if the adoption does not work out, you must return your
Schipperke back to the Rescue Program? Yes      No
Do you understand that CRSC Rescue requires all animals to be spayed/neutered?
  Yes     No
Do you agree to license this dog and give regular health care?  Yes     No
Do you agree to contact CRSC if you can no longer keep the dog?  Yes     No
Are you willing to allow a representative of CRSC to visit your home by appointment?
  Yes     No
Do you understand that the Central Rockies Schipperke Club reserves the
right to refuse an applicant?  Yes     No

Preference:   Male    Female        Age    

If you have marked a preference, would you be willing to consider a suitable dog of a different   
Age  Sex

Do you give permission for the CRSC to pass your application to other Schipperke rescue groups if the CRSC does not have a suitable dog to place with you?
Yes     No

All of the information I have given above is true and complete. I understand that should an animal become available for adoption, I will be asked to sign a legal Contract regarding said adoption. I will provide the animal with a secure ID tag for identification purposes which will be worn at all times. I will obey any and all animal control regulations governing the area in which I live and to license this dog according to such regulations within one month of adoption. I agree not to sell, trade, transfer ownership, abandon or dispose of this dog in any way, but to notify CRSC if I must relinquish custody of the dog. This includes release to family members. I agree to allow a CRSC representative to examine the dog and his or her living conditions and to surrender this dog to said representative if the conditions are found unsatisfactory. I agree to assume full responsibility for this dog's actions and for any damage that might be done by this dog. I agree to keep this dog as my household pet and companion an be sure dog is in a secured area when unattended. The dog will not be allowed to roam free at any time. I agree to never chain or tie this dog unattended. In accordance with common sense, I agree never to allow this dog to be transported in the open bed of a pickup truck or similar vehicle.


Comments:   


  
 
 

Send correspondence to: 
Jennie Doerksen, Secretary
Central Rockies Schipperke Club of Greater Denver
PO Box 370504
Denver, CO 80237-0504
Email:  CRSCSecretary@Schipperke.com
 
 

© 1997 - 2012 Central Rockies Schipperke Club of Greater Denver Inc.
Website created and maintained by Kristen Henry