Just complete this form. Click on Submit when ready to send. Make sure your email address is correct and your references are listed.

Number of adults in household?

1 2 3 4 or More

Number of children In household?

None 1 2 3 4 or more

Please list sex and ages of children:
Who will be responsible for the care and training of the Cocker Spaniel?:
Approximately how long will your Cocker 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:

Is your yard fenced?:

Yes No

If yes, please describe the type of fencing, area fenced and height:

If your yard isn't fenced, would you consider fencing part or all of it as a condition of adoption?:

Yes No

Are you willing and able to modify your daily schedule to accomodate a Cocker Spaniels needs, such as going outdoors into a fenced area or walking on a leash to perform bodily functions at least 4 times a day?:

Yes No

Are you aware of the importance of keeping a Cocker Spaniel on a 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

If you have dogs now, are they spayed/neutered?:

Yes No

Have you ever owned a Cocker Spaniel?:

Yes No

Have you ever participated in dog shows?(Shown your dogs?):

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

Where will your Cocker sleep at night?:

Would you be able to take your Cocker to
obedience training if it was having some behavioral problems?:

How would you describe your household activity level?

In addition to a regular life at home,
would your Cocker:

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 female Cocker Spaniel?

What age would you prefer?

Any Puppy (under 1 year) 1-3 years old 4-6 years old 7-9 years old Senior(over 9 years)

What color are you interested in?

Check as many as you desire

Is there any dog currently listed on our site you are interested in?

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?:

Do you currently have a vet?:

Vet's name, address and phone number:

Please add any comments you feel that would help us better understand you and your home as a potential Cocker Spaniel owner.