Please fill out the fields below so we can learn about your family and home. This helps us make the best match for you and the rescue dog. This is only the first step in the process of applying. Filling out the application does not obligate you to our rescue.

Your full name:

Street: City:

State: Zip: Email:

Daytime phone/cell: Evening/nighttime phone:

Your occupation/title: I now live in a House Townhouse Condo Apartment Mobile Home Other

Number of adults/children in household Ages of family members

I am interested in adopting a Male Female Either Do you have a fenced yard? Yes No

Do you have a swimming pool? Yes No If yes, does it have a cover? Yes No

Is someone home during the day? Yes No Will the dog be allowed in the house? Yes No

Tell us more about your family. Also please mention why you want to adopt a Cairn.

Do you now or have you ever owned a terrier? Yes No Owned a Cairn? Yes No

Please describe this experience, and tell us about your experience with dogs, cats and other pets:

Vet info: Vet phone:

Interested in joining the Cairn Terrier club? Yes No