Adoption Application
Please note that the personal information in this form will be used to get in touch with you. If you leave this information blank, we will have no way of contacting you. If you would rather talk to someone in person or if you have submitted this form and no one has contacted you, please call 512-527-9923. Home and veterinary checks are done prior to placement.

If the application doesn't seem to be working, please complete this text version and send it to us by copying it into the body of an email.


If you wish to prepay your adoption fee, you may do so by clicking on the following button. Please send us an email to let us know that you have prepaid.
Personal Information
First Name
Last Name
Spouse Name
Street Address
City
State
Zip
Home Phone
Work Phone
Email
Cell
Name age and relationship of human members of the household
Employer
How Long?
City
State
Phone
Living Situation
Own or Rent home
Fenced Yard?
What type and height
renting
  
If renting is pet deposit required?
Is there a pet size limitation?
Name of Landlord
Phone number

Nearest relative not residing with you
*emergency purposes only
Home phone
Work Phone
Cell Phone
Dog Care
How did you hear about our organization?
Which cocker spaniel are you interested in?
Why do you want a cocker spaniel?
Who will be the primary care giver of the dog?
Where will the dog be kept?
Please explain
How much time will the dog spend outside?
When you are home where will the dog be kept?
Where will the dog sleep?
What kind of food will you feed your pet?
Do you currently have other animals that live with you?
Please list type, and if they are dog friendly.
Have they been tested for feline leukemia/heartworn or canine heartworm?
Are their vacincations current?
Are they neutered?
What other animals have you had and what happened to them?
Veterinarian's Name

Vet's Phone Number
If you are changing vets, please specify both the new and old information
Do you have any special criteria for a dog that would live at your house?
If a behavioral or housebreaking issue arises, what steps would you be willing to take to work on it?

Is anyone in the household allergic to pets?



How many hours a day maximum, will the animal be alone?
How would you describe the activity level in your household?
What activities are you hoping to do with your pet?
What type of temperment are you looking for in a pet?
If you leave town, who will take care of your pet(s)?
Phone
Who will take care of your pet if something happens to you?
How long do you intend to keep your pet?
Are you aware that the average lifespan for a cocker spaniel is estimated to be 12-15 years of age?



If for any reason you are unable to keep your dog, do you agree to notify Cocker Rescue and return the dog immediately?



Are you aware and do you accept that Cocker Spaniel Rescue requires a non-refundable adoption fee for our dogs?



Please read carefully: As part of the adoption process, our organization does follow-ups on our placements. We will call and, if we deem necessary, do a home visit. You also understand that the adoption is not final for 30 days following placement. During that time, you are fostering our rescue. We reserve the right to void the adoption and pick up the dog. People adopting cockers from cocker spaniel rescue must understand that the organization has no Background information on the animal's previous environment, behavioral problems (if any) and medical history. We can provide a current behavioral evaluation and medical history only. Some diseases have long incubation periods and a negative test is not a guarantee that the animal does not have a certain disease. Introduction of a new animal into a home with existing animals carries a certain risk that must be assumed solely by the adopting party. Cocker spaniel rescue cannot be held liable for damages that may result from such an introduction. We are in an organization operating as a community service with the intent to do only good and no harm. Your signature on this agreement is your promise to have your cocker protected from canine heartworm. In addition you promise to provide food, shelter, love and all medical attention your pet requires. In the event that you are unable to keep your cocker, you are required to inform cocker spaniel Rescue as soon as possible and to keep the animal until we can find a suitable home or return the animal to us. When you adopt an animal from cocker rescue, the cocker will have a collar and id tag. The tag is registered to this organization. You are strongly urged to have your own id tag made immediately. If the animal is picked up and traced to our organization because your tags are not on it, you may not get your pet back. We accept very few excuses for "loose" animals. If you are submitting this application online, you will be required to sign a hard copy of this application at the time of adoption.
Signature of Adopter
Date