English Toy Spaniel Rescue Adoption Form
Mail to:
English Toy Spaniel Rescue
Please print clearly
Name _____________________________________________________________
Spouses/Partner Name ________________________________________________
Street Address ______________________________________________________
Home phone_______________ Work number_______________ Cell phone _____________F AX___________
Best time to call? _________________________
Occupation(s)____________________________________________________________________________
I live in a________________________________________________________________________________
If other please explain______________________________________________________________________
Do you own or rent? _______If you rent do you have permission from your landlord to have a dog?________
Landlord’s name/phone number_______________________________________________________________
If less than 1 year, list previous address _________________________________________________________
Do you have a secured fenced yard? ____________ What type of fence? ____________________
If no, how will you handle toilet duties? ____________________________________________________________
Do you have a dog house? __________ Describe ______________________________________
How many adults in your household? ________ List the age and sex ____________________________________
How many children in your household? ________ List age and sex of children _____________________________
Have you owned and English Toy Spaniel before? ________
If no how did you hear about this breed? __________________________________________________________
Do you currently own any other dogs? ________
If yes, list breed/sex/age ________________________________________________________________________
Have you ever owned other dogs? _______ What breeds? ______________________________________________
How long? _____________ What happened? ________________________________________________________
If the dog passed away, when did this happened? ______________________________________________________
Do you own cats? _______ How many? ___________ How long? ________________________________________
How would you rate yourself as a dog owner? _________________________________________________________
How would you rate the activity level of your home? _____________________________________________________
How you ever adopted a rescued dog before? _________ If so explain ________________________________________
Where will the English Toy Spaniel spend the day? ________________________________________________________
Other- please explain ______________________________________________________________________________
Where will the English Toy Spaniel spend the night? _______________________________________________________
Other please explain _______________________________________________________________________________
On average, how many hours a day will the English Toy Spaniel be alone? ____________________________
If more than 5 hours, are you willing to make arrangement for the dog to have a break…i.e. pet-sitter, family member,
daycare, other? _______ Explain _____________________________________________________________________
Do you have a regular veterinarian? _______ Name/address/phone ___________________________________________
___________________________________________________________________
What are your reasons for wanting an English Toy Spaniel? __________________________________________________
Are you interested in breeding? _____________ If so, why? ________________________________________________
Sex preference? ____________ Age range? __________________ Color preference?____________________________
If there is a dog currently listed on our website in which you have a particular interest, who is that? ____________________
Are you willing/prepared to continue work on housebreaking a rescue? __________________
Are you willing to adopt a dog with medical needs or one who is on medication? _____________
Would you be willing to let a representative of Lucky Star English Toy Spaniel Rescue visit your home by appointment?
____________ If no, why?_________________________________________________________________________
Do you agree to contact Lucky Star English Toy Spaniel Rescue if you can no longer care for this dog? ________________
What reasons would you have for surrendering or returning a rescue? __________________________________________
______________________________________________________________________________________________
Is everyone in your household agreeable to the adoption of a rescue? __________________________________________
Are you aware of the inherited health problems that English Toy Spaniels may face? ___________________________
Please list ______________________________________________________________________________________
Are you willing and able to deal with these problems should they occur? ___________________________________
Have you read the FAQ and preamble to this application? _________________
What else would you like us to know about your and or/your family that would help us to make a good match and assist in determining if yours would be a good home for a rescue?
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Signature
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Date
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