DALMATIAN ASSISTANCE LEAGUE (CCDAL)
Are you or your
spouse in the military or reserves?
Have you applied
to another rescue or shelter?
How long at this address?
If less than 2 years, please list your previous address:
Does your home
have a yard?
If you have a yard, is it Fenced? Yes
Height/Type of fence?
Is the fence
attached to your home?
Do you have a
Are you familiar
with the Dalmatian breed and their requirements?
you walk/exercise a dog ON leash?
you walk/exercise a dog OFF leash?
When you are
home, where will the dog be kept?
When no one is
home, where will the dog stay (be specific)?
Where will the
dog sleep at night?
Who will be
responsible for feeding and taking the dog outside?
Who will be
responsible in the absence of the primary caretaker?
What reading or
other steps have you taken to prepare for a new dog?
Are you willing
to obtain an appropriately sized, open-wire crate?
What will you do if your
newly adopted pet does not get along with your other pets for a while?
If so, please
Are you willing to take
time to housebreak a dog?
Do you understand that changing a dogís environment may cause the dog to
What type of veterinary
care do you plan to provide?
Please check all of the
following that will apply to your new dog:
Do you currently have other pets?
Indoor or Outdoor?
<add any additional pets you have now, or have
had in the last 10 years, at the bottom of this document along with any
other vets used>
If your pets are cats
and/or dogs, are they all spayed and/or neutered?
If not, why?
Do any of your pets have
an infectious disease now, or have they in the recent past?
If yes, what?
I certify that
the information provided on this form is true and correct. I am also
financially able to care for this animal. I understand that proper food and
veterinary care will be costly and am able to meet these requirements. I
understand that a home check is mandatory prior to adoption and that
follow ups may be conducted for up to one year. I understand that any false
statements constitute grounds for confiscation and surrender of the animal.
I further understand and agree that CCDAL may demand return of the animal
for any violation of the terms of the adoption contract and agreement.
Should the animal be returned to CCDAL I understand that I will be
responsible for any fees and expenses incurred in the reclamation of the
dog, but not limited to legal and/or medical fees.
I have read
and understand the above statement
name(s): Signed Date:
WE RESERVE THE
RIGHT TO REFUSE ANY ADOPTION.