Relinquishment Application

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

Japanese Chin's Name*

Age*

Sex*

Male

Female

Color*

Size*

Health*

Temperment*

Has this dog ever behaved aggressively towards a person including biting? **

Rent

Own

If ‘Yes’, please explain

Has this dog behaved aggressively toward other dogs? **

Rent

Own

If ‘Yes’, please explain

Background - Tell us a little about your Chin's history. Where did you get your Chin?*

Special Considerations

City*

State*

Zip*

Your Name*

Your E-Mail*

Your Phone Number*

Additional Information or Instructions for JCCARE

Please upload a picture you have of your Chin (max: 10mb)*

Max. file size: 10 MB.

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