Puppy Application Page

Name *

First

Last

Address *

Please enter Mailing Address including City, State and Zipcode

Phone Number:

Email *

Your Family and home: Please tell us a little about your family and home situation:

House
Condo
Apartment

Household members: Please let us know if there are any chldren and/or pets in your household. If so please let us know number of and ages of children, type of animal and age of pet(s)

Who in your household will be the primary caregiver for the puppy?

Is there a person in your household who is any of the following: *

Elderly
Disabled
Has special needs
Allergic to dogs
None of these apply

What breed and size are you looking for?

Do you have a sex or color preference?

Your Puppy experience: Please tell us about your prior experience with puppies and dogs. (First time puppy families are welcome to apply.) How many dogs have you owned in your lifetime? (copy)

Selected Value: 0

Please click on the slider to select a number between 0 and 10 or more.

Have you ever raised a puppy? ( Please do not include your parents raising a puppy when you were growing up) *

Yes
No

Have you ever surrendered a dog to shelter or rescue or taken one back to a breeder? *

Yes
No

If Yes, please explain:

Name three temperament qualities that you hope for your puppy to have. You can be totally honest!

1. 2. 3.

Plans for your puppy: Please tell us a little bit about how you plan to integrate your new puppy into your family. LIVINING SITUATION FOR YOUR PUPPY. Please describe the living situation for the pupply: Is someone home during the day at your house? *

Yes
No

How many hours daily would the dog be left alone? *

If no one is at home during the day, would you plan for someone to come into your home to let the puppy in and out during the potty training stage? ( A doggy daycare if run properly, can be an excellent choice for working new puppy parents as well once your puppy has had all of his/her vaccines.)

SLEEPING: Where do you plan on having your puppy spend the night? (Please be specific, e.g., in a kennel in the garage, in a playpen, in the kitchen, in a crate in my bedroom, on the bed with my kids, etc.)

How did you hear about us? (Please select all that apply)

Internet Search
InstaGram
Facebook
Client referral
Word of Mouth
Other

If Other was selected above, please tell us more about how you found us.