, Cavalier King Charles Spaniel Club - USA - Rescue Application
CKCSC Promise
Regions
IL, IN, IA, KS, KY, MI MN, MO, ND, SD, NE, OH, OK, TX, WI
CT, DE, DC, ME, MD, MA, NH, NJ, NY, RI, PA, VT, WV
AL, AR, FL, GA, LA, MS, NC, SC, TN, VA
AK, AZ, CA, CO, HI, ID, NV, MT, NM, OR, UT, WA, WY
 
Cavalier Rescue USA Application
www.cavalierrescueusa.org

Rescue Logo


Welcome to the Cavalier Rescue USA rescue application. Please complete all information below and then hit the “Submit” button at the end of the page.

Once your application is on file with us, all you need to do is to bookmark the rescue website page for your region and then call or email the contact person listed when a dog is posted who is of interest to your family and whose stated needs you meet. Let the contact person know of your interest in the dog and also that you have an application on file since applicants who have been waiting for a rescued Cavalier are normally given preference over those who newly contact us (all things being equal). Thank you for your interest in Cavalier rescue!



  
 Name:
 Spouse's/Partner's name:
 Address:
 City:     State:     Zip: 
  Home Phone:    Cell #:     Work #: 
  Email Address: 
 Occupation:     Best time to call: 
 Spouse / Partner Occupation: 
 Do you live in a house, condo, townhome, apartment, trailer, other? 
 Do you own or rent the place in which you live? 
 
If you rent do you have the landlord's permission to keep a dog? Landlord's name
and phone number:

 Years at current address: 
 If less than 1 year, previous address: 
 
 Do you have a securely fenced yard? 
If yes, What type of fencing? (i.e. wood, metal, electric)
 
 
 
If there are other adults in the home besides you and your spouse/partner, please list their names and their relationship to you.  
 How many children are living in your home? 
 Age and sex of children:   
 
 Have you owned a Cavalier before?
If yes, from whom or where was your Cavalier from?
 
If not, how did you
hear about this breed?
 
 Do you currently own Cavaliers or dogs of other breeds?
 If yes, list the breed, sex and age:   
 
Does your dog/s have any current behavioral issues?
If yes, please describe the issues and how they are being managed.
 
 
What type and brand of food is your current dog/s eating? If you do not currently have a dog, what type and brand of food did you feed your dog and what type and brand would you plan to feed your new dog?
 
Are dogs allowed on furniture in your home?
Comments:
 
 
Do you walk your current dog off leash, with a leash?
 
Have you ever owned a Cavalier or a dog of another breed? 
 
Please tell us about your history of ownership with dogs. For each dog, list the breed/breed mix, how long you had the dog, and the cause of death or re-homing of each dog. 
 
Have you ever given a pet away to another person or to a shelter or rescue group?
If yes, please outline the circumstances:
 
 
Do you own cats?     How many?    For how long? 
 
Do you own pets other than cats or dogs (i.e. birds, rabbits) ?
If yes, please list the type of pet and number of them:
 
 
Where will the Cavalier spend the day?


 
Where will the Cavalier spend the night?

 
In general, what is your family's typical schedule? 
 On average, how many hours a day will the Cavalier be home alone without an adult over the age of 21 present? 
 If you are traveling, for example, going on vacation, what arrangements do you plan to make for the care of your dog?
 
 
Do you have a regular Veterinarian?  Name, Address and Phone:
 I give permission to call my veterinarian for a reference. 
 
 
What are your reasons for wanting a Cavalier and for applying to rescue a Cavalier?

 Check as many preferences that apply:
Sex:
Age:

Would you interested in adopting a pair of Cavaliers? 
Are you willing to adopt a dog who is not aggressive, but who is shy or fearful and requiring extra socialization? 

Would you potentially be interested in adopting a Cavalier who required ongoing medication or who had special needs? 

Would you consider a senior Cavalier (age 10 and up)? 
 
 Would you be willing to let a representative of the Cavalier rescue organization visit your home by appointment? 
 
 Do you agree to contact Cavalier Rescue USA (aka CKCSCR Inc.)
rescue if you can no longer keep or care for this Cavalier?
 
 Are you applying to adopt a specific Cavalier? If yes, please list the dog's name and city/state below. Also, very important, please contact the person listed on the dog's page so they know of your interest.
 
What else would you like us to know about you and your family that would help us to make a good match, and assist us in determining if you'd be a great home for a rescued Cavalier? :
 
  

By submitting this application you agree and understand that Cavaliers are house dogs and are not to be housed outdoors or left outside anytime when an adult is not home and able to supervise them.

All of the information I have given above is true and correct. I understand that if any of my responses above are not true, that Cavalier Rescue USA reserves the right to confiscate any dog they have adopted to me. Should I adopt a dog from this organization. I agree to provide the dog with proper and sufficient food, water, shelter, training, medical care, companionship and humane treatment at all times. I further agree that Cavalier Rescue USA (aka CKCSCR Inc.) is in no way liable or responsible for any damage, accident or injury resulting from the placement of a dog into my household.


We reserve the right to refuse any person or persons from fostering or adopting a dog from our organization.

  

CKCSCR INC., revised 09/2013