adoption Test may be deleted

ATTENTION!! PLEASE READ THIS PRIOR TO FILLING OUT YOUR APPLICATION

Please answer this "getting to know you" application with detailed answers. ONLY through your complete answers will we be better able to help you determine which Col. Potter Foster Dog would be best suited to you.

After your Application has been submitted and received by the Committee, the entire process can take 2 or 3 weeks.You can help us speed the process along by alerting your personal references that our Reference Coordinator will be contacting them by phone for a reference check. Delays are often encountered when we cannot reach an Applicant's references or their Applications are incomplete. Please verify all telephone numbers and e-mail addresses prior to submitting your application.

During peak holiday periods and vacation times, it can take longer as we are all volunteers and have jobs and other life functions, outside of rescue.

If you intend to use an electronic fence as your primary means of containment, we cannot accept your application.

We cannot guarantee any of our recue dog’s behavior with children and cannot accept applications with children under 12 unless you already own or have owned a rescued Cairn during the child’s lifetime. We reserve the right to deny an application based on the age of the child under 12 at the time of ownership.

If you have never owned a dog, a rescued Cairn may not be for you. You should read Toto: The Untold Story (https://www.cairnrescue.com/resources/toto-the-other-side-of-the-story/) before applying. We also have many approved homes waiting for a dog and we prefer to adopt to those with terrier experience.

The Fine Print

Col. Potter Cairn Rescue Network (CPCRN) reserves the right to decide the placement of their rescue Foster Dogs. CPCRN reserves the right to deny placement of their rescue foster dogs.

By filling out the below application, you agree to notify CPCRN once you no longer are looking for a Cairn. You also agree to notify us if there are any changes in your household, which would relate to questions you have answered in this application.

You MUST be 21 years of age or older in order to apply to adopt a rescue Foster Dog through CPCRN. Photo identification may be required upon adoption.

ATTENTION!!

Before applying to adopt any dog, PLEASE read the Adoption FAQs (Frequently Asked Questions) section. (https://www.cairnrescue.com/service/faq/)

You will have only 60 minutes to complete the form. If you fail to complete the form in 60 minutes you will timeout and lose all your data entered. Please review the form and the requested information before you begin. Have all your references, numbers, addresses, etc. before beginning.

* = Mandatory field

Name of person filling out this form: *

Are you the applicant? *

Yes
No

If NO, indicate why you are filling out this application for another party

Applicant Name *

Co-Applicant Name

E-mail *

Address 1 *

Address 2

City *

State *

Zip/Postal Code *

Primary Phone *

Work Phone

Cell Phone

Indicate the best time for a Rescue Contact to call you *

List any other Rescue(s) and/or Shelter(s) from which you have recently applied for adoption

Have you ever applied to adopt from CPCRN before? *

Yes
No

If yes, did you adopt, what was year you adopted, and the Col. Potter name of the dog you adopted?

When did you last apply to/adopt from CPCRN?

List all ADULT FAMILY members who currently reside in the household by name, age, and occupation, INCLUDING YOURSELF:

Name

Age

Occupation

List all ADULT (NON-FAMILY) members who currently reside in the household by name, age, and relationship to you:

Name

Age

Relationship

List all RESIDENT children under 18 years of age by name, age and relationship to you:

Name

Age

Relationship

List other children under 18 years of age who VISIT FREQUENTLY by name, age, relationship, frequency and typical duration of visitation:

Name

Age

Relationship

Duration and Frequency

List the hobbies/activities in which you and your family participate:

What energy level would you prefer your Cairn to have? *

Mellow
Sofa-buddy
Energetic
Somewhere in between

Do any members of your household have allergies? *

Yes
No

If yes, list the members and describe the reaction to animals

For whom are you adopting the dog? *

Myself
My Spouse
My Child
Other

Does everyone in the household know that you are applying for a rescue dog and do they all agree? *

Yes
No

If you answered NO, explain:

Why do you want to adopt a Cairn Terrier or Cairn Mix? *

Why did you choose rescue? *

What specific characteristics are you looking for in your future rescue cairn? *

For example, playmate for resident pet(s), companionship for you, good fetching ability, potential agility or earthdog candidate, etc.

What is the ONE most important factor you are seeking in a Cairn? *

Are there any specific issues you absolutely cannot tolerate in your rescue cairn? *

For example, inappropriate barking, housebreaking, etc.

Many of our rescues come with "baggage". How do you plan to work through this? *

How long do you feel is the appropriate time needed to work through issues with your rescue Cairn? *

Have you ever previously owned a dog? *

Yes
No

How many dogs have you owned in the past 15 years?

How long has it been since you've had a pet in your home other than to visit?

Describe in detail the pets that are no longer with you for any reason, and tell us why

If no pets, please put None

IF you previously owned a Cairn/Cairn-Mix, when was it?

If never owned, please put Never

What research, if any, have you done on the Cairn breed to insure they are the desired breed

List all CURRENT pets by Name, Species, Age, Gender, Spay/Neuter, temperament, and current health.

If no pets, please put none

Tell me a bit about [EXISTING PET(S)].

Playfulness, sociability, any other significant thing you can think of…this will help find the right new family member for you.

In what type of home do you live? *

Is your home a: *

Single Story
Bi-Level
2 Story
Other

If you live in a Condo or apartment, do you live on the ground floor or an upper level?

Ground Floor
Upper Level

Do you have stairs leading to or inside your home and how many are there?

Describe the size of your home. Include square feet.

Do you rent or own your home? *

Own
Rent

If you rent, does your landlord allow pets?

Yes
No

If you rent, provide the following information:

Landlord Name:

Address:

City

State/Province

Zip Code

Phone

How would you describe the area in which you reside?

Urban
Suburban
Semi-rural
Rural

If you have a yard, is it fenced? *

Yes
No

If yard is fenced, describe the materials & height of fence, and size of yard:

Do you have electric (hidden/underground) fencing or plan to install it? *

Yes
No

If you do not have a fence, describe how you plan to keep your dog from roaming off of your property

Do you agree that Cairns should NEVER be left off-leash or outside unless securely fenced in? *

Yes
No

Where will the dog be kept during the day?

INDOORS:

Loose
Crated
Basement
Other

OUTDOORS:

Who will be responsible for feeding, housebreaking/training? *

Myself
My Spouse
My Child
Other

Are you willing to take your dog for obedience lessons if necessary? *

Yes
No

Will anyone be home during the day? *

Yes
No

If so, who will be home and what are their responsibilities with a new dog?

Describe the exercise schedule you will have for your dog: *

How many hours a day will the dog be left INSIDE unattended? *

How many hours a day will the dog be left OUTSIDE unattended? *

When you are away on trips, where will the dog be kept?

Home, someone comes over to feed
Pet sitting service
Board at dog kennel
Other

After the dog has been adequately house-trained, where will it sleep at night? *

What do you intend to feed the dog? *

Would you consider adopting a dog that is not yet housebroken? *

Yes
No

If YES, how will you housebreak the dog? (provide details):

What gender dog do you prefer? *

If you selected a gender preference, would you still consider a Cairn of the opposite gender? *

Yes
No

What age range are you willing to consider for your future rescue Cairn? *

Would you consider a dog outside of that range, if it was otherwise a good match? *

Often the exact age of rescue dogs is unknown.

Special Needs dogs could be of any age. They could be Cairns with a vision or hearing loss, or have some other medical condition. They could be dogs in their twilight years who need a loving home for the rest of their lives.

Would you consider a special needs Cairn? *

Yes
No

Are there any cairns on our website (www.cairnrescue.com) that appeal to you?

Are you willing to adopt from any part of the country or is there a geographic area limit? *

Please note that your choices will be limited if you must concentrate on one small geographic area. You will have more options if you are willing and able to adopt from a larger geographic area. We will provide you with more information on our specific transport policies for our rescues, but in summary, you are responsible for transporting your future rescue cairn to your home - both financially and logistically. We can help you plan this, and your rescue's foster family may be able to help with the transport, other volunteers may be able to help with the transport (note that we request 20 cents per mile fee for any volunteer who helps transport your dog to you - more on that later), but the final responsibility is yours. Flying your rescue cairn - whether as cargo or as carry-on - is an option for some of our rescues but not all.

(list your one-way driving mileage limit):

List any other details about you/your family that will help us match the best Cairn to your home *

FOUR PERSONAL REFERENCES ARE REQUIRED in addition to your current veterinarian. Only one of these references may be a family member. All references must be 21 years of age or older. NOTE: If you do not provide 4 personal references, your application will be rejected.

REFERENCE 1

First Name *

Last Name *

City *

State *

Phone *

Relationship *

Best time to contact

REFERENCE 2

First Name *

Last Name *

City *

State *

Phone *

Relationship *

Best time to contact

REFERENCE 3

First Name *

Last Name *

City *

State *

Phone *

Relationship *

Best time to contact

REFERENCE 4

First Name *

Last Name *

City *

State *

Phone *

Relationship *

Best time to contact

If you have had pets in the past, list the information for the vet that cared for them. Also include an additional Veterinary reference if you have used your current Vet for fewer than 4 years.

If you do not currently have a vet, provide the information about the vet that you will be using when you adopt a dog.

VET REFERENCE 1

Name of Practice: *

Name of Doctor:

Address:

City *

State *

Phone *

Is this Vet: *

Current Vet
Previous Vet
Not used yet

If this is a CURRENT vet, list how long you've used this vet and the names of the animals treated:

If this is a PREVIOUS vet, list how long ago you used this vet and the names of the animals treated:

VET REFERENCE 2

Name of Practice:

Name of Doctor:

Address:

City

State

Phone

Current Vet
Previous Vet
Not used yet

If this is a CURRENT vet, list how long you've used this vet and the names of the animals treated:

If this is a PREVIOUS vet, list how long ago you used this vet and the names of the animals treated:

Where did you hear about us?

INTERNET:

WORD OF MOUTH

Do you agree to keep the dog licensed with appropriate information at all times? *

Yes
No

Do you agree to comply all City, Country, State and Federal rules as they pertain to dog ownership? *

Yes
No

Do you agree to contact Cairn Rescue if you can no longer keep this dog? *

Yes
No

Are you willing to provide a crate for your rescue Cairn to help during the transition period? *

Yes
No

Do you agree to allow a rescue representative to visit your home by appointment to do a "safety" ins *

Yes
No

If NO, state your reason for declining:

Are you able and willing to make a Rescue Adoption donation if you adopt a Cairn or Cairn mix through Col. Potter Cairn Rescue?

Yes
No

PLEASE NOTE: At the time you adopt one of our rescue Cairns, you will be asked to make a donation to CPCRN. This donation helps defray shelter fees and other costs paid to procure our Rescues, the cost of transporting them to our foster homes, the costs of providing them with food and appropriate veterinary care, including spay/neuter, immunizations, heartworm testing and prevention, and other medical and/or grooming needs as are required by the particular dogs in our program. The requested adoption donation for young Cairns between the ages of 1 and 6 years is typically between $325.00 and $375.00, depending upon their age; for Cairns 6 years and over, it is typically $200.00. For Cairns in their golden years or which have long-term health issues, the requested adoption donation is usually reduced based on the age of the Cairn and/or the care and medications that the Cairn will require post-adoption. For young puppies under the age of 12 months, the requested adoption donation is typically $400.00, and if the puppy is not altered prior to placement (which would typically be the case if the puppy is under 6 months), we also require that the adopting family agree to a spay/neuter deposit. This deposit is FULLY refundable upon presentation and verification of a spay/neuter certificate. This is further explained in the rescue protocol for young puppies, which you will receive if you are applying for a pup under six months of age. Please verify the requested donation amount on any dog that you are considering for adoption. As adoption donations do not constitute purchase monies paid for the Rescue, they are not refundable in the event that you decide to return the Rescue or for any other reason.

By submitting this application, you give us your permission to call all of your listed references, including your Veterinarian(s), to determine responsible pet ownership. If you have included a work telephone number for any of your references, you are stating that they may receive telephone calls at their place of employment.

Your signature(s) will be required on a formal Adoption Contract prior to adopting any rescue dog. You must also provide proof of being of legal age in your state to sign contracts. Photographic identification with your current address may be required prior to adoption.

I understand that CPCRN may, at its sole discretion, determine that a Cairn rescue will not be approved for adoption by me or my family.

Please make sure the application is complete and you have entered your e-mail address before pressing the "Submit" button below. Incomplete applications may be rejected or delayed.

PLEASE NOTE: Adopting one of CPCRN's rescue Cairns is a multi-step process. Please see our Frequently Asked Questions for details on how the adoption process works.

I represent that the information that I have provided on this form is the truth to the best of my knowledge and belief. I/we hereby give my/our permission to CPCRN to use any of the above information to confirm that this rescue application is deemed to be correct. I hereby certify that I have not been convicted or otherwise been found guilty by any governmental authority of animal cruelty, neglect or abandonment, or of failing to provide adequate shelter to an animal.