PUPPY APPLICATION

Primary Contact Name

Cell Phone

Alt Number

Secondary Contact Name

Relationship to Primary Contact

Cell Phone

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

How did you find us?

Do you prefer a male or female?

List your (3) color preferences.

What is Primary's occupation? Do you work from home?

What is Secondary's occupation? Do you work from home?

If you work outside the home, what is your puppy care plan?

Do you have children living at home? If so, what are their ages?

Do you have children that don't live at home but visit on a regular basis?

Have the children been exposed to dogs?

Do you own or lease your home?

Are your children skittish around dogs?

By checking this box, I agree that my lease agreement states that I may have a dog.

Have you ever owned a dog before? If so, what breed was it?

Do you have a dog now?

If you currently own a dog, select one:

List # of, names, ages, and breeds of dogs currently living at home.

Do you have any other pets at home? If so, what are they?

Is your yard securely fenced? If not, what is your plan to keep your puppy safe?