You may either download this form and do the application online, or print it out and mail it to our office address.  You may also Copy and Paste this form into a word processing document and email it to the the above address.

Adoption Application

Carefully check each dog's page before you apply. You will see pertinent contact information at the bottom of each. Make certain to contact the person listed about the dog you wish to adopt.

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(s) of dogs you wish to adopt _________________________________________

Applicant Name: ________________________________________________________

Address:  ______________________________________________________________

   ______________________________________________________________

Home Phone: ___________________________________________________________

Work Phone: ___________________________________________________________

Cell Phone: _____________________________________________________________

E-Mail Address: _________________________________________________________

1.      Why do you want to adopt a dog?

2.      What do you think are the most important responsibilities in owning a dog?

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

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

5.      Are you willing to take the time to work with a dog on housebreaking issues, should the need arise?          __yes __no

6.      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? __yes __no

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

8.      Does any member of the family have any allergies to animals? __yes __no

9.      If yes, please explain:

10.  For whom are you adopting the dog? __self __gift

11.  Have you ever owned a pet before? __yes __no

If yes, what kinds of animal(s) and when?

12.  Which of these pets do you still own?

13.  Please describe any pets you still own, in as much detail as possible (type, age, sex, etc.).

14.  Is/are the animal(s) spayed/neutered? __yes __no

15.  Which pets do you no longer own?

16.  What happened to him/her/them?

17.  Were they spayed/neutered? __yes __no

18.  Have you ever given any of your animals away for any reason?

a.       ___yes ___no

b.      If yes, please explain the reason(s):

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

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

21.  Do you have a different vet in mind for your new pet? __yes __no

    If yes, please specify, and kindly say why you are changing vets.

22.  What kind of veterinary care do you intend to provide?

23.  Have you done or do you intend to do any reading in preparation for a new dog? Please specify:

24.  Will you consider obedience training for your dog? __yes __no

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

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

       __yes __no

27.  How many people currently reside in your household? _____

28.  Are there children in your household? __yes __no

If yes, what are their ages?

29.  Do they have experience handling animals? __yes __no

If yes, please explain:

30.  Do children frequently visit your home? __yes __no

31.  Is everyone equally enthusiastic about adopting a dog?

    ____yes ____no    Please explain:

32.  How would you describe the activity level in your household?

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

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

35.  Do you own or rent your residence? __own __rent

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

37.  Are pets allowed?   ___yes  ___no

38.  Do you live in a:

a.       _____ Single family home

b.       _____ Duplex

c.       _____ Townhouse

d.       _____ Mobile home

e.       _____ Condominium

f.        _____ Apartment

g.       _____ Other (please explain):

39.  Are there any restrictions or covenants where you live?

a.       ___yes ___no

b.      If yes, please list them:

40.  Do you have a fenced yard? __yes __no

41.  If yes, how high is the fence?

a.       What type of fence is it?

b.      Any holes or gaps or weak areas?

c.       If you do not have a fence, do you plan to get one? __yes __no

d.      If so, when?

e.       If not, why not?

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

43.  Where will the dog be kept? __indoors only __outdoors only __both in/out (explain):

44.  How much time will the dog spend outdoors?

Explain:

45.  Will anyone be home during the day? __yes __no

46.  How many hours will the dog be left unattended?

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

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

49.  Where will the dog sleep?

50.  Will you keep a collar, with a tag bearing your name and number, on your dog at all times? ___yes ___no

51.  How often do you travel?

52.  What will you do with the dog when you travel?

53.  What will you do with the dog if you move/change housing?

54.  Are you or your spouse with the military? __yes __no

55.  Have you ever bred or raised dogs? ___yes ___no

56.  Please estimate the annual cost of the following:

a.       Premium Food (Many Cockers have food allergies) $__________

b.      Grooming (Every 6-8 weeks, minimum) $__________

c.       Vet Care (including necessary shots, heartworm preventative , ear, eye and teeth maintenance)         $__________

d.      Extras (Toys, treats, beds, bowls, leash, collar, id tag) $__________

57.  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).

         ___yes ___no

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

59.  Are you aware and do you accept that the ARF requires a non-refundable donation of $250 for our dogs?     __yes __no

60.  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? __yes __no

61.  If this is a long distance adoption, are you willing to:

a.       __ Travel to get the dog (by plane or car or both?)

b.       __ Pay for the costs of transportation.

c.       __ Meet somewhere along the way.

d.       __ Unable/Unwilling to travel or assume costs.

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

        ___yes ___no

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

        ___yes ___no

64.  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 ARF? ___yes ___no

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

66.  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 the ARF has the right to annul the adoption and reclaim the dog.

I give the ARF 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 ARF 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 the ARF’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 ARF, I may be considered for another dog.

Signature:                                                                           Date:

_________________________________________                  _____________________

Printed Full Name:

_________________________________________

Forms modeled after those used by Cocker Spaniel Adoption Center.