CDR Adoption Application

Cayuga Dog Rescue Adoption Application

Please remember that the application must be fully completed to be accepted.

Where did you hear about us?

Name of dog or puppy for which you are applying:

Your Full Name (first and last):

Your Spouse's/Partner's Full Name (first and last:

Street Address:
NO PO Boxes Please!

City:
State:

Zip Code:

How many years have you lived at the above address?

Years Months

I live in a:

House Apartment Mobile Home With Parents

Do you own or rent?

Own Rent

If you rent, what is the name and phone of your landlord?

Name
Phone Number

Your Home Telephone Number:

Your Alternate Telephone Number:

E-mail address:

Are you 21 years of age or older?

Yes No

Place of Employment:

Work Telephone Number:

Are you moving in the foreseeable future?

Yes No

If Yes, what will happen to the dog?

How many adults and/or children live in your household?

Adults Children

Children's Ages

Which members of your household will be responsible
for the care and training of the dog?

What are your reasons for wanting to adopt this dog or pup?

Have you YOURSELF owned and been the person responsible for the care and vet bills of:

Dog Cat Puppy

Have you adopted from a shelter or rescue group before?

Yes No

Name of Shelter/Rescue Group:

Location of Shelter/Rescue Group:

Is someone home during the day?

Yes No

If Yes, please give details:

If not, for how many hours will the dog be alone
including commute time?

Describe where the dog will be when you ARE home-which room(s), yard, dog house, garage, basement etc.

Describe where the dog will be when no one is home--
(rooms, yard, dog house, garage, basement,
doggie daycare, take to work etc.)

Where exactly will the dog sleep at night?

If adopting a puppy, who will do the housebreaking and
how will this be accomplished?

How will you confine the dog when it is outdoors?

Please tell us about all the people the adopted dog would usually come in contact with (baby sitter, extended family, children, visitors, roommates etc.)

What arrangements will you make for the dog
when you travel or are on vacation?

Under what circumstances would you feel it
necessary to give up or return a dog?

Is there a baby in your future? (If so we'll send information on helping your dog adjust to a new baby.)

Yes No

I plan to let my dog get exercise in:

In my own yard that is presently fenced
On a cable run
On a chain or tie out
Off-leash in my unfenced yard

I will provide the dog with:

a short walk per day a long walk per day
two walks per day run or jog per day
unable to provide daily walks

My/Our training plan:

I/We will train our dog at home ourselves
I/We will enroll our dog in obedience classes
Would like more information on training

My dog or puppy needs to be comfortable in a crate all day.

Yes No

Your Current Pets:

Pet's Name	Breed	Age	Sex	Fixed?	Name of Owner on Vet Records

If your current pet(s) is/are not spayed or neutered,
please tell us WHY NOT.

Please list cats and/or dogs you have owned in the past:

Pet's Name	Dog, Cat, etc	Name of Owner on Vet Records	Year Last Owned	What Happened to the Pet?

Your Current Veterinarian

Current Vet's Telephone Number

Names of animals treated by current vet:

Your Past Veterinarian

Names of animals treated by past vet:

Is there any other information you
would like us to know about you?

By submitting this application I am certifying that I am at least 21 years of age and intend to be the legal owner and the person responsible for the care and well-being of any dog I adopt from Cayuga Dog Rescue.

In submitting this application I give Cayuga Dog Rescue representatives permission to contact my vet (and landlord if applicable) for information to assist them in determining whether or not to place an animal with me.
A home visit is part of the Cayuga Dog Rescue adoption process.

The above application MUST be fully completed to be accepted.

IF you DO NOT receive a response within FIVE days, please contact us again!

1) Please be aware that any dog adopted from CDR may never be given away/rehomed to another person for ANY reason without CDR's written permission.

2) Please note that all adopters will be asked to sign an ADOPTION CONTRACT accepting possession of, title to (subject to the conditions of the adoption contract), and responsibility for the dog adopted and agreeing to release and discharge CDR forever from liability for any injury or damages to any person or property caused by the adopted dog, and from any causes of action, claims, suits, or demands whatsoever that may arise as a result of such injury or damages.

PLEASE NOTE: When you submit this application, you will immediately receive a confirmation.
If you do not receive confirmation, please resubmit your application.

Click here to view CDR's ADOPTION CONTRACT