Application Information:

Name:

Email (if available):

Address:

 

 

Telephone (home):                                                        (work)

List members of your household (e.g. husband, children ages 3 and 6)

Is any member of your household allergic to animals : Y   N   unknown

If yes, explain.

Do you live in a (circle one): Home/Apartment

Do you (circle one): Rent/Own

If you rent, will you be able to provide a letter from your landlord approving the dog's presence?

Are you planning a move or any change in your household dynamics in the next 6 months (major renovation, etc)?

Do you have a yard? (circle one): Yes   No

Fenced? (circle one): Yes  No

Do you have a pool (circle one): Yes  No

Why do you want an English Cocker Spaniel?

 

Have you ever had an English Cocker before? If not, are you familiar with grooming requirements and common health problems?

 

How committed are you to getting an EC vs another breed? Please state if you are you looking into any other breeds at this time.

Do you have a preference for age, sex or color?

Would you be interested in information about dogs that would be at a distance, i.e. a dog that would have to be shipped or brought to you ?

What previous animals have you owned, where are they now, and if deceased, how did they die?

Could you handle a special needs dog (e.g. blind,deaf,chronic or active medical problem)? Consider those things with which you might have experience or general expertise e.g. a vet tech)

What qualities are you looking for in a dog?

What qualities do you wish to avoid?

What other animals do you currently own?

Are they spayed/neutered? What are their ages?

What are the ages of children and people who visit frequently?

If there are no children currently, are there plans for the same in your future?

Do any of your household members smoke? (circle one): Yes/No

How do you plan to use your English Cocker Spaniel? (eg hunting, obedience, companion/pet)

Who will care for the dog primarily?

Is someone home during the day?

Where will the dog be during the day, during the night or when on vacation?

How do you plan to exercise your dog?

Where will you have the dog groomed?

Will you agree to a home check and follow up visits that may be unannounced?

References:

Name:                                                                    Telephone: 

Name:                                                                     Telephone:

Name:                                                                      Telephone:

Veterinarian:                                                             Telephone:

Groomer:                                                                  Telephone:

Applicant Signature:                                                    

Date: