Cocker Spaniel
*NOTE: When you copy the app, please remove the lines before you fill them in and it will work better if you are having problems.
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Address________________________________________________________________ City______________________________________ State__________ Zip__________ Email address__________________________________________________________ Home Ph:____________________________ Business Ph:__________________________ Occupation(s)_________________________ Employer____________________________ Occupation(s)_________________________ Employer____________________________ Number of Adults in Household___________ Number of Children in Household_________ Please list sex and ages of children: ______________________________________________________________________ Who will be responsible for the care and training of the Cocker Spaniel? ______________________________________________________________________ Approximately how long would you expect your Cocker to be alone each day? ______________________________________________________________________ Do you live in a: [ ] Single family home [ ] Mobile Home [ ] Condominium [ ] Apartment? If you rent or lease, you must have written permission from your landlord. Please list landlord's information: Name_______________________________ Phone_____________________________ Address________________________________________________________________ City________________________________ State__________________ Zip________ *Note- Living in an apartment or condominium WILL NOT disqualify you for adopting a Cocker Spaniel as long as you are able to exercise your dog regularly and meet the rest of the guidelines satisfactorily. Is your yard fenced? [ ] Yes [ ] No If yes, note the approximate size of the fenced area, and height and type of fencing material. ______________________________________________________________________ If your yard is not fenced, would you consider fencing all or part of it as a condition of adoption? [ ] Yes [ ] No Are you willing and able to modify your daily schedule to accommodate a Cocker Spaniels' needs, such as going outdoors into a fenced area or walking on a leash to perform bodily functions at least four times daily? [ ] Yes [ ] No Are you aware of the importance of keeping a Cocker Spaniel on leash or in a fenced area when it goes outside? [ ] Yes [ ] No Cocker Spaniels are primarily house dogs. They can be kept outdoors for short times in a kennel or dog house with an attached run. They cannot be chained or tied outdoors, nor left outdoors alone for long periods unsupervised. Do you agree to these conditions? [ ] Yes [ ] No Is there a local ordinance in your area pertaining to owning/housing an animal (i.e. leash laws, required vaccinations, dog licenses, etc.) [ ] Yes [ ] No Are you willing to keep a collar with a tag bearing your name, address, phone number, etc. on your Cocker at all times? [ ] Yes [ ] No If for any reason, you are unable to keep your Cocker Spaniel, will you agree to return it to this adoption center? [ ] Yes [ ] No Are you willing and able to accept full care, costs, and necessary burdens and responsibility of owning a pet? [ ] Yes [ ] No How many dogs have you owned in the past ten years?____________________________ Please list each dogs' breed, sex, name and age. (If you no longer own the dog, please note what became of it) _____________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ What other pets do you have?________________________________________________ ________________________________________________________________________ Have you ever bred or raised dogs? [ ] Yes [ ] No Have you ever owned a Cocker Spaniel? [ ] Yes [ ] No Have you ever participated in dog shows? [ ] Yes [ ] No Have you ever trained a dog before? [ ] Yes [ ] No If yes, what commands were taught? ____________________________________________ ________________________________________________________________________ Are you familiar with crate training? [ ] Yes [ ] No If no, would you be willing to learn more about it and consider the use of a crate (portable cage) as a training and transitional aid? [ ] Yes [ ] No How would you describe your household activity level: [ ] very quiet [ ] rather easygoing [ ] usually something going on [ ] lots of activity Estimate number of times per month that adults visit your home? ____________________ Estimate number of times per month that children visit your home? ____________________ In addition to a regular life at home, would your Cocker Spaniel: [ ] Walk routinely with a family member? [ ] Compete in obedience trials? [ ] Go to obedience classes? [ ] Go to your place of business with you? [ ] Travel with you? [ ] Be a playmate for your children or pets? Would you prefer a male or a female Cocker Spaniel? [ ] Male [ ] Female [ ] No preference What age would you prefer? [ ]Any [ ] Puppy (under 1 year) [ ] 1-3 years old [ ] 4-6 years old [ ] Senior (7+ years old) What color are you interested in (check as many as you want) [ ] Any [ ] Buff [ ] Black [ ] Chocolate [ ] Black and Tan [ ] Black and White Parti [ ] Red and White Parti [ ] Chocolate and White Parti [ ] Sable [ ] Tri-color [ ] Chocolate and Tan [ ] Black and White Occasionally, a Cocker Spaniel with special needs (physical restrictions or health problems or an unusual personality or preferences) is available for adoption. Would you be interested in being considered for such a "special" dog? [ ] Yes [ ] No Please add any additional information or thoughts that you feel would help us to understand you and your home as a potential Cocker Spaniel owner. ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Do you currently have a veterinarian? [ ] Yes [ ] No If yes, please list your veterinarian's name, address, and phone number: Name____________________________________ Phone__________________________ Address_________________________________________________________________ City_____________________________________ State_____________ Zip__________ Please list two personal references that you have known for more than two years that are not relatives: Name____________________________________ Phone__________________________ Address_________________________________________________________________ City_____________________________________ State_____________ Zip__________ Name____________________________________ Phone__________________________ Address_________________________________________________________________ City_____________________________________ State_____________ Zip__________ ________________________________________ Name _____________________________ Date ________________________________________ Name |
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