Please be sure to click the submit button on the bottom of the page.
There may be an occasional problem with the forward of this application to my
email. We reply to all inquiries, if you have not gotten a reply within four days, please send a private
email.
Just complete this form. Click on Submit
when ready to send. Make sure your email address is correct and your references
are listed.
Your name:
Email address:
Address:
City:
State:
Zip:
Home Phone:
Business Phone:
Occupation(s):
Employer(s):
Number of adults in household?
Number of children In household?
Please list sex and ages of children:
Who will be responsible for the care and training
of the Cocker Spaniel?:
Approximately how long will your Cocker be alone
each day?:
Do you live in a:
Single
family home
Mobile
home
Condominium
Apartment
If you rent or lease, you must have written permission
from your landlord.
Please list landlord's information:
Is your yard fenced?:
Yes
No
If yes, please describe the type of fencing, area
fenced and height:
If your yard isn't fenced, would you consider fencing
part or all of it as a condition of owning a Cocker?:
Yes
No
Are you willing and able to modify your daily schedule
to accomodate a Cocker Spaniels needs, such as going outdoors into a fenced
area or walking on a leash to perform bodily functions at least 4 times
a day?:
Yes
No
Are you aware of the importance of keeping a Cocker
Spaniel on a leash or in a fenced area when it goes outside?:
Yes
No
Cocker Spaniels are primarily house dogs. They can
be kept outdoors for short times in a kennel or dog house with an attached
run. They CANNOT be chained or tied outdoors, nor left outdoors alone for
long periods unsupervised. Do you agree to these conditions?:
Yes
No
Is there a local ordinance in your area pertaining
to owning/housing an animal(i.e. leash laws, required vaccinations, dog
licenses, etc)?:
Yes
No
Are you willing to keep a collar with a tag bearing
your name, address, phone number, etc. on your Cocker at all times?:
Yes
No
If for any reason, you are unable to keep your Cocker
Spaniel, will you agree to contact the breeder first?:
Yes
No
Are you willing and able to accept full care, costs,
and necessary burdens and responsibility of owning a Cocker?:
Yes
No
How many dogs have you owned in the past ten years:
Please list each dogs' breed, sex, name and age.
(If you no longer own the dog, please note what became of it):
What other pets do you have?:
Have you ever bred or raised dogs?:
Yes
No
If you have dogs now, are they
spayed/neutered?:
Yes
No
Have you ever owned a Cocker Spaniel?:
Yes
No
Have you ever participated in dog shows?(Shown your
dogs?):
Yes
No
Have you ever trained a dog before?:
Yes
No
If yes, what commands were taught?:
Are you familiar with crate training?:
Yes
No
If no, would you be willing to learn more about it
and
consider the use of a crate (portable cage)
as a training and transitional aid?:
Yes
No
Where will your Cocker sleep at night?:
What would be the reason you would give up a pet?:
Would you be able to take your Cocker to
obedience training if it was having some behavioral problems?:
Yes
No
How would you describe your household activity
level?
Estimate the number of times per month adults visit
your home:
Estimate the number of times per month children visit
your home:
In addition to a regular life at home,
would your Cocker:
Walk routinely with a family member?:
Yes
No
Compete In obedience trials?:
Yes
No
Go to obedience classes?:
Yes
No
Go to your place of business with you?:
Yes
No
Travel with you?:
Yes
No
Be a playmate for your children or pets?:
Yes
No
Would you prefer a male or female Cocker
Spaniel?
What age would you prefer?
What color are you interested in?
Check as many as you desire
AnyBuffBuff
and White
Buff
and TanRedRed
and White Parti
BlackBlack
and WhiteBlack
and Tan
Black
and White PartiTricolorChocolate
Chocolate
and White PartiChocolate
and TanSableRoan
Is there any dog currently listed on this site you
are interested in?
Occasionally, a Cocker spaniel with special needs
(physical restrictions or health problems, as in a rescue and such
or an unusual personality or preferences)
is available to a good home.
Would you be interested in being considered for such a "special"
dog?:
Yes
No
Do you currently have a vet?:
Yes
No
If yes, please list your veterinarians
name address and phone at the bottom of this questionaire
in the vet section. Please list two personal references that you
have known
for more than two years that are NOT relatives.
Vet's name, address and phone number:
Please add any comments you feel that would help
us better
understand you and your home as a potential Cocker
Spaniel owner.