Adoption Application

Please take a few moments to review our Adoption Agreement before filling out application.

Adoption Application

"*" indicates required fields

A. Personal Information

Applicant Name*

First Last

Co-Applicant Name (if any)

First Last

Address*

Street Address City State ZIP Code

Email*

Best Phone Number to Reach You*

Hours applicant is at work

Best time of day to call applicant

How often does applicant check e-mail?

Everyday

2-3 times/week

Once a week

Once a month

Rarely

Has applicant placed an application with any other rescue groups?

Yes

If yes, for what breed and what is the status of the application?

B. Your Preferences

What gender Cairn are you willing to adopt?*

No preference

Male only

Female only

Prefer male, but would consider female

Prefer female, but would consider male

What age Cairn would you consider?*

check all that apply

Puppy (under 1 yr)

Youngster (1-3 yrs)

Teenager (4-7 yrs)

Mature (8-10 yrs)

Senior (11+ yrs)

Would you consider a Cairn mix?*

Yes

Would you be willing to adopt a Cairn with any of the following special needs?

check all that apply

If other, please specify:

Would you consider a Cairn that still requires housetraining?*

Yes

What energy level would you prefer in your Cairn?*

No preference

High Energy

Couch Potato

In the Middle

Would you consider a puppy mill survivor that may be shy?*

Yes

Are you willing to work with a Cairn that has behavior issues such as:*

Excessive barking

Escaping

Digging

Separation anxiety

Aggression towards other dogs

None of these

check all that apply

Are you willing to work with a Cairn that needs obedience training?*

Yes

What would you do if the Cairn you adopt starts to challenge you, nips you, or nips a member of your family?*

If you have made arrangements to ensure your pets will be cared for in the event of your death, please explain:*

Are you interested in any of our currently available dogs?*

Yes

Not applicable

If yes, please specify which dog(s):*

We do not ship dogs to their adoptive homes. How far are you willing to drive to adopt a new dog?*

Have you been in touch with a CRUSA representative about this Cairn(s)?

Not required, but if so, please specify:

Please provide any other information about you or your family that might help us find the right match for you:

C. Household Information

Applicant Age*

Co-Applicant Age

Applicant's Occupation*

Co-Applicant's Occupation

List all family members and their ages*

Please note that for the safety of our dogs and of our applicants' children, Cairn Rescue USA will not place a dog with a family that has children under the age of 7 years unless the family can prove to our satisfaction one of the following: (i) that the parents have owned Cairns, Westies, and/or Scottish-terriers in the past; (ii) that the child has been raised with Cairns, Westies and/or Scottish terriers, knows how to interact with a dog, and is not afraid of dogs, and/or (iii) that the family is involved in dog rescue. For the reasons behind our policy, please refer to our FAQs. If you have children under the age of 7 years and believe you meet these criteria, please explain:

What experience have your children had with dogs?

How much responsibility will the child(ren) have in the care and management of the Cairn?*

Not applicable

None

Minimal

Some

Maximum

How much adult supervision will the dog and the child(ren) have?*

Not applicable

None

Minimal

Some

Maximum

Are there children under 18 years of age who frequently visit the household?*

(i.e, grandchildren, stepchildren, frequent houseguests, neighbors, babysitters)

Yes

If yes, please list by name, age, relationship, and frequency of visitation:

What experience have these children had with dogs?

Are any members of your household allergic to dogs, hair, or dust or have asthma?*

Yes

If yes, please describe:

For whom are you adopting the Cairn?*

Myself

My spouse

My child

My family

Other:

If other, please specify:

Does everyone in your household approve of getting a Cairn?*

Yes

If no, please explain:

Please check all that apply:

I have worked or volunteered with an animal shelter before

I have volunteered with a dog rescue group before

I have adopted a rescue dog before

I have taken a dog I owned to obedience classes before

I show dogs in conformation or performance events

I belong to an online Cairn terrier/terrier mix list

If you checked any of the above, please specify:

D. Pet Ownership

Why do you want to adopt a Cairn?*

Why do you want to adopt a rescue dog?*

If you have done any research with respect to adopting a rescue dog, please specify:*

What do you think are the most important responsibilities of dog ownership?*

Have you previously owned a Cairn?*

Yes

If you have never owned a Cairn, what research have you done to ensure that this breed is the proper one for you?*

Do you understand that Cairns adopted through Cairn Rescue USA will be spayed/neutered prior to adoption?*

Yes

How many dogs have you owned in the past 10 years?*

Please list your current pets by name, breed/type/species, age, gender, spay/neuter condition, and current health:*

Please describe the pets that are no longer with you. List breed or type, age, and why they are no longer with you:*

If you currently have more than one dog, please describe how they get along:*

E. Home Information

In what type of home do you live?*

Single family

Townhome

Condominium

Apartment

Mobile home

Other:

If other, please specify:*

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

Not applicable

Ground floor

Upper Level

If you live in a single family or townhome, does it have stairs in it?*

Yes

Not applicable

If yes, please describe where they are and how often the dog will need to use them:*

Does your home have a deck or balcony?*

Yes

If so, would a Cairn fit through the space between the railings?*

Yes

Approximate height of railing:*

Do you rent or own your home?*

Own

Rent

If you rent, how long have you lived in your current home?*

If you rent, does your landlord allow pets?*

Yes

If you rent, are you willing to provide CRUSA upon request with a copy of your lease or a notarized statement from your landlord authorizing pet occupancy?*

Yes

Do you have a yard or patio for your Cairn to use?*

Yes

If yes, is the area fenced?*

Yes

If fenced, of what material is the fence made?*

Not applicable

Wood

Chain Link

Other:

If other, please specify:*

Height of fence in feet:*

Have you inspected the fence for holes that a Cairn could crawl or dig through?*

Yes

If there is not a fenced yard/patio, how many leashed walks will you provide each day?*

Who will be responsible for the daily care of your Cairn (feeding, walking, training, etc.)?*

Myself

My spouse

My child(ren)

Other:

check all that apply

If other, please specify:*

Will anyone be home during the day?*

Yes

If so, who will be home and what will their responsibilities for the Cairn be?*

How many hours a day will your Cairn be indoors:*

How many hours a day will your Cairn be outdoors:*

When your Cairn is outside:*

Please check any and all that apply

If other, please specify:*

How many hours a day will your Cairn be left alone?*

When alone, where will your Cairn be kept?*

Run of the house

In a crate

Confined to a room

Garage

Basement

Other:

If other, please specify:*

Where will your Cairn sleep at night?*

If necessary, how will you housetrain your Cairn?*

Do you have a crate of adequate size for your Cairn (i.e Varikennel 200) or are you willing to provide one prior to adoption?*

Yes

Note: A crate is used by the Cairn as a den, for time alone, feeding, travel, sleeping, etc. It is NOT meant to be used to confine the Cairn all day long while its owner is at work. An exercise pen or a babygated area should be used instead.

Are you willing to have your home visited by a CRUSA representative (by appointment) to do the home safety inspection required by CRUSA's application process?*

Yes

Are you able and willing to make an adoption donation if you adopt a Cairn or Cairn mix through rescue?*

Yes

F. References

Please provide three personal references and provide a phone number where they can be best reached! Only two references should be a family member. Please indicate your relationship to your reference (family member, friend, neighbor, co-worker, etc.). All references must be 18 years of age or older.

Reference 1:*

First Last

Address*

Street Address City State ZIP Code

Best Phone Number to Contact*

Hidden

Work Phone Number (with permission)

Email*

Relationship*

Best time(s) to call*

Reference 2:*

First Last

Address*

Street Address City State ZIP Code

Best Phone Number to Contact*

Hidden

Work Phone Number (with permission)

Email*

Relationship*

Best time(s) to call*

Reference 3:*

First Last

Address*

Street Address City State ZIP Code

Best Phone Number to Contact*

Hidden

Work Phone Number (with permission)

Email*

Relationship*

Best time(s) to call*

Veterinary Reference(s)

If you have used your current vet for less than two years, please include an additional veterinary reference. If you do not currently have a vet, either (i) provide information for the vet you will be using when you adopt your Cairn, or (ii) if you have had pets in the past 15 years, list the information for the vet that cared for them.

Vet Reference 1:*

First Last

Name of Practice*

Address*

Street Address City State ZIP Code

Phone Number*

Vet Reference 2:

First Last

Name of Practice

Address

Street Address City State ZIP Code

Phone Number

G. Where You Heard About CRUSA

Where did you hear about us?

Internet search engine

Cairn terrier chat/email list

Link from another rescue site

Shelter

Rescue representative business card

Dog show/pet event

Friend

Other:

If other, please specify:

H. Agreement

Name

This field is for validation purposes and should be left unchanged.