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We would like to thank you for filling out this form. I have tried to ask questions that could affect the puppy in some way and also help me to get names, etc correct and help with any confusion on my part. I show puppies by appointment only. After I receive your information I will contact you by email or by phone call.
1. Please provide the following contact information:
Name
Street Address
Address (cont)
City
State/Province
Zip code
Country
Home phone
Cell Phone
Work phone
Fax
2. Are you over the age of 18
Yes
No
3. Do you have children
Yes
No
4. Are you a college student
Yes
No
5. Is this your first pet
Yes
No
6. Do you have any other pets
Yes
No
7. If Yes, what kind
Dog
Cat
Other
8. What breed are you interested in
Boston Terriers French Bulldogs Jack Russells Toy Poodles Westies Other
9. Do you want a male or female
Male
Female
10. What are you wanting this puppy for
Family pet
Breeder
11. Do you agree to spay/neuter your puppy
Yes
No
12. Is everyone in your household in agreement about getting a puppy
Yes
No
13. Are you prepared to care for this puppy for the next 10-18 yrs
Yes
No
14. Do you rent or own your home
Rent Own
15. If you rent, does your lease include pets and do you have your landlords permission
Yes
No
16. Who will be the primary caretaker of the puppy
17. Do you plan on going to an obedience class with your puppy - I recommend at least a puppy class.
Yes
No
18. How many hours a day will the puppy be alone, are you able to go thru the day to take the puppy potty
19. Have you ever given a dog up to a shelter or rescue? If yes, please explain.
20. Have you lost a dog to Parvo in the last 12 months? If yes, plese explain.
21. Do you have a fenced yard
Yes
No
22. If you don't have a fenced yard, how ill you exercise & protect the dogs?
23. Do you need the puppy shipped
Yes
No
24. If yes, to what airport? give 1st & 2nd choices for major airports
25. Do you understand I take the puppies on Monday mornings for the vet checks & health certificates and ship on Tuesdays (days to ship are subject to change)
Yes
No
26. Do you understand that if you put down a deposit it is NON-REFUNDABLE?
Yes,I understand & agree to the terms?