CROSSWINDS WELSH SPRINGER SPANIELS
ADOPTION QUESTIONAIRE
NAME: ____________________________________________________________________________
STREET ADDRESS:________________________________________________________________________
CITY:________________________________________STATE:______________ZIP:____________________
PHONE: Home:______________________ Cell: _________________Other:____________________
E-MAIL (1)_________________________________ E-MAIL (2)_________________________________
- Why do you want a Welsh Springer Spaniel? ________________________________________
___________________________________________________________________________________
- Have
you ever met and/or spent time with a Welsh Springer Spaniel? Y( ) N( )
- Have you ever owned a Welsh Springer Spaniel before?
Y( ) N( )
- Housing arrangements in which you currently reside: Check all that apply.
(
) City ( ) Rural ( ) Suburban
(
) House ( ) Apartment ( ) Condo ( ) Own ( ) Rent
Yard
( ) Fenced ( ) Unfenced ( ) None
If yard is fenced, what type of fencing do you use? _________________________________
If you rent, do you have your landlord’s permission to house a dog?
Y( ) N( )
Landlords’ Name:____________________________________ Phone:___________________________
5.
Do you own any of the following for your Welsh Springer Spaniel?
Airline Crate Y( )
N( ) Size:________________________________
Other type of Crate
Y( ) N( ) Size:________________________________
Kennel Run
Y( ) N( ) Size:________________________________
6. Do you work outside of the home?
Y( ) N( )
If so, what are your work hours? (include travel time)_________________________________________
Will someone be home during these work hours to care and give support to this dog? Y( ) N(
)
If no one will be home, where will the dog be kept during your work hours? _______________
7. Where will the dog’s primary living area be? (
)lives outside ( ) lives inside ( ) both
Where will the dog be allowed?____________________________________________________________
Where will the dog sleep?_________________________________________________________________
8. Do you have children? Y( ) N( ) How many? _______ Ages:
______________________________
9. Have you had dogs before? Y( ) N( )
What happened to the dogs? ______________________________________________________________________________________
______________________________________________________________________________________
10. Do you have pets now? Y( ) N( )
Kinds:______________________________________
11.Would you consider attending obedience classes? Y( )
N( )
12. Will you take this dog to the vet regularly?
Y( ) N( )
Will you keep this dog current on immunizations? Y(
) N( )
Will you keep this dog on Hartworm prevention, if required in your area? Y( ) N( )
Will you have an electronic I.D. tag inserted
in the dog? Y( ) N( )
13. Are you willing to be financially responsible for this dog? Y( ) N( )
14. What will you do with this dog when you go on vacation?_______________________________________________________________________________________
15. What will you do with this dog if you have to move to another home of location?_______________________________________________________________________________________
______________________________________________________________________________________________
16. How did you learn about Welsh Springer Spaniels?_____________________________________________
______________________________________________________________________________________________
You can copy / print this form or Contract breeder for a Word file of this applications. crosswinds.sandyb@gmail.com.
You can e-mail the completed word file or FAX the completed form to 951-639-0269.
These are the adoption questions recommended by the Welsh Springer Spaniel Club of America.
All Welsh Springer Spaniel puppies are sold with
restricted registrations unless otherwise stated.
CROSSWINDS WELSH SPRINGER SPANIELS
Sandy Bretto, crosswinds.sandy@gmail.com , www.crosswindswss.com
, (951) 232-7976, FAX 951-639-0269
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