Cocker Spaniel Adoption Center, Inc.: Cocker Spaniel Adoption Center: We rescue cocker spaniels and cocker spanie

You must complete each question on this application. Incomplete applications will not be considered. Please answer each question in as much detail as possible, providing phone numbers and appropriate contact persons as requested.

Name:

Address:

Phone number(s) and type(s):

E-mail:

How did you hear about CSAC?

Preferred method of contact (phone, email):

I am applying to be approved for adoption when "the right dog" is available through CSAC.

I am applying to be approved to adopt a specific dog currently available through CSAC. I am interested in (dog's name):

Why do you want to adopt a dog?

What do you think are the most important responsibilities of owning a dog?

Why do you want to adopt a Cocker Spaniel in particular?

How long has it taken you to decide to adopt a Cocker Spaniel?

Are you willing to take the time to work with a dog on housetraining issues, should the need arise?

Do you understand and accept that changing a dog's environment may cause the dog to have accidents, especially in the early days of the adoption?

If a behavioral problem arises, what steps will you take to work on it?

Does any member of the family have any allergies to animals? If yes, please explain.

For whom are you adopting the dog (i.e. self, family, gift)?

Have you ever owned a pet before? If yes, what kinds of animals and when?

Which of these pets do you still own? Please describe these pets in as much detail as possible (name, type, age, gender, etc.).

Is/are the animal(s) spayed/neutered?

Which pets do you no longer own? What happened to him/her/them?

Were these animal(s) spayed/neutered?

Have you ever given any of your animals away for any reason? If yes, please explain the reason(s).

What do you consider a good and valid reason for giving up a dog?

What is the name and phone number of the veterinary hospital where your animal(s) has/have received care and vaccinations?

Do you have a different vet in mind for your new pet? If yes, please specify, and kindly say why you are changing vets?

What kind of veterinary care do you intend to provide?

Have you done or do you intend to do any reading in preparation for a new dog? If yes, please specify.

Will you consider obedience training for your dog?

Do you have any experience with obedience training? If so, please specify.

Would you be willing to obtain a crate if recommended for the dog?

How many people currently reside in your household?

Is everyone equally enthusiastic about adopting a dog?

How would you describe the activity level in your household?

Are there children in the home? If yes, what ages?

If there are children in the home, do any have experience with animals? Please explain.

Do children visit your home regularly or occassionally? If yes, please explain.

Who will be responsible for feeding the dog and taking him/her outside?

In the absence of the primary caretaker, who will take care of the dog?

Do you own or rent your residence?

If you rent, what is the name and phone number of the landlord?

Are pet(s) allowed in your residence?

What type of dwelling do you reside in (single family home, townhouse, condominium, etc.)?

Are there any restrictions or covenants where you live?

Do you have a fenced yard?

Please describe the fence (height, material, gaps/weaknesses).

If you do not have a fence, do you plan to get one?

If so, when? If not, why not?

Would you walk/exercise a dog on or off-leash, or both?

Where will the dog be kept (indoors only, outdoors only, both)? Please explain.

How much time will the dog spend outdoors? Please explain.

Will anyone be home during the day?

How many hours will the dog be left unattended?

When you are home, where will the dog be kept?

When no one is home, where will the dog be kept?

Where will the dog sleep?

Are you willing to keep a collar with a tag bearing your name and phone number on your dog at all times?

How often and for what reasons do you travel?

What will you do with the dog when you travel?

What will you do with your dog if you move/change housing?

Are you or your spouse in the military?

Have you ever bred or raised dogs?

Have you ever participated in dog shows?

Will you provide a smoke-free environment for any dog you adopt? (Please note that this question is asked because many cockers have allergies and skin problems and should not be placed in a home where there is smoke).

Please estimate the cost of the following: Premium Food (many Cockers have food allergies), Grooming (every 6-8 weeks, minimum), Vet Care (including vaccinations, heartworm preventative, ear, eye, and teeth care), and Extras (toys, treats, beds, bowls, leashes, collars, id tags).

Are you able to comfortably provide the estimated care, and are you prepared for possible other costs, in addition to your estimation (Examples: sickness, accidents, emergency care)?

Are you aware and do you accept that CSAC requires that all dogs and cats in the household be spayed/neutered before an adoption of a CSAC dog can take place?

Are you aware and do you accept that CSAC requires a fee of $300 for dogs under the age of eight years and $250 for dogs eight years and older?

The average Cocker Spaniel has a lifespan of 12 to 15 years. Are you willing to make a commitment to this dog for the rest of his/her life?

Are you willing to provide the necessary love and attention, as well as the necessary food, vet care, and grooming required to maintain a happy, healthy Cocker Spaniel?

If this is a long distance adoption, are you willing to travel to get the dog (by plane, or car, or both), pay for the costs of transportation, meet somewhere along the way, unable/unwilling to travel or assume costs?

Have you reviewed and do you understand and accept the CSAC adoption contract?

If, for any reason, you are unable to keep your dog, do you agree to notify CSAC immediately?

If you are unable to keep your dog, do you agree to return him/her to CSAC without hesitation?

If this is a long distance adoption, and you are unable to keep your dog, are you willing to assume the responsibility, including travel and financial responsibility, for returning the dog to CSAC?

Please list any preferences you have in adopting a dog (age, sex, breed, personality, etc.).

Please list any concerns or final questions here:

I have read the above information carefully and have filled out this application honestly. I understand that omission of information and/or failure to answer all questions and sign the application can result in this application being declined. Also, if an omission or untruth is discovered after an adoption takes place, I understand and accept that CSAC has the right to annul the adoption and reclaim the dog. I give CSAC permission to fully investigate the information provided as well as contact veterinarians and related officials. If the application passes this review, I agree to a home and yard visit on a mutually agreed date by a CSAC representative before an adoption decision is made. Furthermore, I understand and accept that the adoption decision depends upon many factors, including ? but not limited to ? the compatibility of the family and home to the individual dog and other applications received on the dog. I understand and accept that it is CSAC's prerogative to decide which home is most appropriate for the individual dog, and therefore I will not take issue with the decision. Unless otherwise indicated by CSAC, I may be considered for another dog.

Cocker Spaniel Adoption Center, Inc. PO Box 1704, Westminster, MD 21158-5704 E-mail: information@cockeradoptions.org