Adoption Application Form | My Site

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Cocker Adoption Application Form

First Name

Last Name

Address *applications with no address listed will not be processed

State

Home Phone

Email

Postcode

Mobile

Identification - Drivers licence or Passport will need to be sighted

PEOPLE LIVING AT THE PREMISES

How many adults?

How many children?

How old are the children?

HOME CHECK

We conduct home checks for the purpose of ensuring that the environment is secure, safe and suitable for a Cocker to be kept in. If during the process of checking a potential adopter’s home it is found to be unsuitable, Cocker Spaniel Rescue Australia (CSRA) are happy to work with applicants to address the issues. If a physical home check is not possible CSRA Inc must be provided pictures of your home, and a referee for us to contact.

QUESTIONNAIRE

We ask all potential adopters to complete a questionnaire so that we can find out more about you, your family and your circumstances. This ensures that the right Cocker is placed with you.

Why do you want to adopt a Cocker Spaniel?

Have you owned Cocker Spaniels previously?

Do your current pets (if any) have any behavior or socialization problems? If so, please explain:

Will the Cocker be an inside or outside dog? *NB CSRA Inc does not rehome Cockers if they are to be kept as outside dogs.

What are your working circumstances? How long would the Cocker be alone each day?

Do you rent or own your property? If renting, please provide a contact number for your Landlord so that CSRA Inc can verify approval to keep pets:

What would you do if your Cocker developed behavioural problems?

Have you ever been refused an adoption with any breeder, other rescue group or shelter? If so, please explain:

Have you ever surrendered an animal to a shelter or released an animal to another party? If so, please explain:

Do you currently have a vet? If so, please provide us with their name and phone number so that we can contact them for a reference:

THIS FORM CONSTITUTES A LEGAL AGREEMENT:

Before you submit it please read this carefully:

By submitting this application, I agree that all the information I have provided is correct. Providing untruthful answers or failure to comply with the requirements of this application can result in the rejection of the application. If said information is found to be misleading or untrue after the adoption has taken place, I agree that the Cocker will be returned to Cocker Spaniel Rescue Australia Incorporated immediately.

By signing and submitting this form, I agree to the following:

• I agree that the Cocker will not be an outside dog.
• I agree that the Cocker will not be used for breeding.
• I agree to allow CSRA Inc to check the references that I provided.
• I agree to return the Cocker to CSRA Inc should the adoption not work out, or should my circumstances change in the future, or for any other reason that I am unable to keep him/her. I will not re-home the Cocker myself. I understand that my adoption fee (minus a $50 administration fee) will only be refunded if this occurs within seven (7) days of the adoption.

All Cocker Spaniels rehomed by CSRA Inc will be desexed prior to adoption, except under special circumstances, in which case the adoption fee will be waived. By signing this application, I agree to have the Cocker Spaniel desexed within seven (7) days of the date of adoption. If for any reason this is not possible, CSRA Inc is to be contacted and other arrangements will be made. I understand that ownership of the Cocker will not be transferred to me until proof of desexing is provided to CSRA Inc.

We appreciate you taking the time to complete this application. Upon review and approval, we will contact you.

CSRA Inc reserves the right to refuse any application without prejudice or explanation.

Signed (Applicants name printed)

Thanks for submitting!

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