LLP FORMS
PLEASE make sure you fill out application completely
Application Type
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Adoption
Foster
Name
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Home Telephone Number
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Cell Phone Number
Date
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Street Address
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City
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State
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Zip Code
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Employer
Work Telephone Number
Employer(Spouse)
Work Telephone Number
Referred By
Dog Interested In
Why do you want a cocker spaniel
Have you owned one before?
Please list the pets you now have in your home
Breed
Sex
Male (NEUTERED)
Male (NOT NEUTERED)
Female (SPAYED)
Female (NOT SPAYED)
Age
Owned Since
Please list the previously owned pets
Breed
Sex
Male (NEUTERED)
Male (NOT NEUTERED)
Female (SPAYED)
Female (NOT SPAYED)
Age
What happened to him/her
Do you
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Own your own home
Own your own condo
Rent a home
Rent in an apartment
If renting, please give landlord's name address, and telephone number. We require written consent for your having a dog. If possible, please include this consent when you return the application.
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How many adults are in your household?
One
Two
Three or more
How many children are in your household?
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None
One
Two
Three or more
Names and Ages of your children
Do you have much contact with grandchildren or other children?
Yes
No
How often?
What are the working hours of the adults in the house?
Where will the dog be kept during the day?
Where will the dog sleep at night?
Where will it be kept when left alone?
Who will be primarily responsible for the care of the dog?
Does anyone in the home have any allergies?
Where and how do you plan to exercise the dog?
Please describe your lifestyle. Is it active? (e.g., hiking, camping, busy in the community, in and out a lot) or is it a more relaxed, structured atmosphere?
This dog will be left alone, without human companionship, for about how many hours per day.
Please describe the perfect dog for your home. Taking into consideration that they vary greatly in temperament, personality, and activity level, what characteristics do you want in your dog?
What characteristics are undesirable?
is older?
is not reliable with children?
has a physical handicap?
Would you accept a dog that
Yes
No
Yes
No
Yes
No
Knowing that some rescue dogs have had little or no training, are you willing to take the dog to obedience classes?
Yes
No
Are you willing to house train a dog, if necessary?
Yes
No
What method have you used in the past? such as:
barking -
chewing -
jumping on furniture -
jumping on people -
Are you willing to give the dog at least two months to adjust to a new environment?
Yes
No
The basic needs of a Cocker (feeding, grooming, shots) average $600 to $800 per year. Any special problems could increase this amount. Does this responsibility present a problem?
Yes
No
A representative from LIFE’S LITTLE PAWS will be required to do a home check to meet all members of the household. When is a good time for this visit?
Some Cockers need to be professionally groomed (approx. $40) about every two months.Does this present a problem?
Yes
No
If you have owned a pet within the past ten years please fill out the following information.
If you now have a pet, when was its last visit to a vet?
Has your dog had shots in the last year?
Yes
No
Has it been tested for heartworm?
Yes
No
When?
Is it on heartworm preventative now?
Yes
No
What kind?
Your veterinarian information
Name
Street Address
City
State
Zip Code
Phone Number
Please note that there is an adoption fee of $300. The adoption fee for puppies is $350 with a $100 retainer to be returned once spay/neuter is proven. For seniors 9+ there is a $100 donation. These fees are to help pay for shots, neutering/spaying, and other medical needs of the dogs and is non-refundable. If the dog you want to adopt was transported from the southern region, there will be an additional fee of $50 to help offset transportation costs for each dog. ____________________________________________________________________________________ I certify that I am 21 years of age or older and that by adopting a dog from LIFE’S LITTLE PAWS that I will become the legal owner and be solely responsible for the care housing and well being of the dog. I further understand that at any time I can’t keep the adopted dog then it can and must be turned back over to Life’s Little Paws. ___________________________________________________________________________________ "RESTRAINT" agreement: I will keep my adopted dog on leash or under my control at all times until the dog has learned voice command to be off-leash. __________________________________________________________________________________ Signature:
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Date:
Email Address
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