Expression of Interest to Adopt Your DetailsCavalier King Charles Spaniel Rescue (Qld) Inc. will only use your personal details to record, assess and manage your application. Your details will not be sold, shared with or otherwise released to any third party without your prior consent.Name of the dog you are applying to adopt*Name First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Phone - Mobile*Phone - OtherEmail* Your living arrangements*I own my own homeI live in a rental propertyI live in someone else's home (eg. my parent's home)If you are in your own home we may request to see a recent Rates Notice. If you are renting, we may request to see written consent from your landlord that you are allowed to keep pets at the property.You and CavaliersWhat is your experience with the Cavalier King Charles Spaniel breed?* What do you know about the potential health issues and grooming requirements of this breed? eg. heart problems, patella problems, eye health, ear health, maintenance of coat, etc* Are you aware that as a result of a physical trait many Cavaliers snore?*Yes, I don't have a problem with thatI wasn't aware, but I don't mindAre you aware that Cavaliers shed fur?*Yes, I don't have a problem with thatI wasn't aware, but I don't mindDo you have any other pets that live at or visit your home?* Dog/s Cat/s Other Pet/s or Animal/s (eg. chooks?) No, we don't have any other pets From time to time, we are responsible for rehoming bonded pairs of Cavaliers. If you are not matched with the dog you have originally enquired about, and we have a pair available for adoption, would you consider taking a pair?* Yes, I would consider taking a pair of Cavaliers No, sorry, I am unable to take a pair Please outline the breed, age and temperament of any other pets that live at or visit your home* Please let us know what you normally feed your dog/s and what you would intend to feed a Cavalier* If you don't have any other pets, simply answer n/aPlease briefly detail the typical daily exercise and activity routine you would be able to provide for a Cavalier, eg. walks, swimming, play, beach visits, etc. How long each session? How many times per week?* We need to consider your activity and lifestyle when trying to match a dog to your home. Please be honest. If you are only able to provide a minimum amount of walking or activity or you like to go on two long walks every day or you go the beach on weekends then we need to know. Some dogs need a lot of exercise and activity and others are happy with a gentle stroll.Do you have any formal dog training experience?*YesNoIf you do have training experience, please briefly describe: Would you consider taking on a dog with health issues?*Yes, depending what the health issues areNo, I would rather not at this stageIf you would be willing to consider adopting a dog with existing health issues, are there any particular issues you have experience in caring for? Are there any particular health issues you DO NOT wish to take on? Who is your current vet / veterinary services provider? Please provide name, address and phone number. We may contact your vet to ask for a reference in respect of your current pet/s.Living ArrangementsAt your home, do you have any of the following:* Polished timber floors Tiled floors Stairs / split level Timber Decking Grassed / lawn area Garden beds Fenced Swimming Pool Unfenced Dam or other water course Other Other details about home and yard environment PLEASE NOTE that a property check will be required prior to approval for adoptionWe require that your yard and garden is SECURELY fenced. Please detail what type of gates and fencing you have:*Please tick all that apply. If you would like to provide further detail please do so below. 4ft fencing 6ft fencing Colorbond Timber Brick Wire / mesh Lockable gates Gates with latch Other Other details about yard, gates and fencing Do you live in an area which has:* Ticks Cane Toads Snakes Other Wildlife None of the above Where will your dog spend time during the day?*Please provide details of indoor and outdoor facilities and access Where will your dog sleep at night?* What do you plan to do / who will be responsible for looking after your dog if you need to be away from home or when you go away on holidays?* Please advise your typical work hours / hours away from home when the dog/s will be left alone* Please outline who else lives at or frequently visits your address, including other adults and children. If you have children, please list their ages and note down any important issues that may need to be considered such as disability or behavioural considerations.* Your PreferencesLet us know if you have a preference for a particular colour* Blenheim Tri-Colour Ruby Black & Tan I'll be happy with any colour! What age group would you be happiest with?* Pup | 12-18 months - PLEASE NOTE WE VERY RARELY HAVE DOGS AGED UNDER 2 YEARS COME INTO CARE. You should expect a very long wait. We suggest you try contacting the Cavalier King Charles Spaniel Club of Queensland to enquire about pups. Young Dog | 2-5 years Mature | 5-8 years Golden Oldie | 8+ years Do you have a preference for sex of the dog?* Only interested in male dogs Only interested in female dogs I would prefer a male, but will consider a female I would prefer a female, but will consider a male I will accept either male or female What sort of qualities and temperament are you looking for?* Very active Moderatively active Low activity Good with kids Affectionate Lives outdoors Gets on with cats Would like to be an only dog Can live with a bigger dog Likes the beach Do you have any other notes on what you're looking for in a Cavalier?* If there are any issues that particularly concern you such as dogs with anxiety, house training/toileting, barking, walking on lead, etc, please note it down so we can discuss it with you.Please tell us what has motivated you to enquire about adopting a Cavalier?* Become a VolunteerWould you like more information on volunteering with Cavalier King Charles Spaniel Rescue (Qld) Inc.?*Yes, I would like to know more about volunteeringNo, not at the momentFor Our InformationHow did you find out about Cavalier King Charles Spaniel Rescue (Qld) Inc.?* Facebook Google search A friend Pet Expo Another rescue/animal group Spoke to one of your Volunteers I would like to join the email list to receive notification of upcoming events and information from time to time*Yes, I would like thatNo, I do not want to go on the mailing listAPPLICANT'S DECLARATIONI have answered all questions honestly* I declare the information I have provided on this form is to the best of my knowledge true and correct. I will keep information private and confidential* I hereby acknowledge the obligation and agree to keep matters of a confidential nature, particularly regarding personal details and the circumstances surrounding surrender and rehoming, confidential and to respect privacy as required by the Privacy Act 1988 (Cth). I understand my application is subject to review and approval* I acknowledge that Cavalier King Charles Spaniel Rescue (Qld) Inc. will use the information on this form to make an initial assessment as to my suitability for re-homing a Cavalier. I understand Cavalier King Charles Spaniel Rescue (Qld) Inc. may conduct further enquiries with me by phone and may also contact my current veterinarian (if any) for a reference. I will agree to a property check, at a mutually agreed time, if requested I acknowledge that Cavalier King Charles Spaniel Rescue (QLD) Inc., reserves the right to decline any application at their discretion. Thank you for your interest in adopting through Cavalier King Charles Spaniel Rescue (Qld) Inc. We genuinely appreciate you taking the time to provide us with as much information as possible. If there is anything further you would like to add to your application, please let us know. CommentsThis field is for validation purposes and should be left unchanged.