CONTACT US

First name

Last name

Co-Applicant's Name (If Applicable)

Short answer

Multi-line address

Country/Region

Address

Address - line 2

City

Zip / Postal code

Phone

Email

Please list the Vet(s) that cares for or has cared for your animals.

Do you

Own

Rent

Live with Family

Other

It other, please explain

Is your backyard fenced in?

Yes

No

What is your Occupation?

Who will take care of the puppy during the day?

Have you or do you currently own any pets?

Yes

No

If you currently have pets, please list type of pet

Are you prepared to provide a puppy with the attention and training he/she needs to be happy well behaved pet?

Yes

No

Do you have kids in your home?

Yes

No

If so, what are their ages?

What type of Dog are you looking for

Female

Male

No preference

Do you have a color preference?

I understand *

I will pay a $300 Deposit and it is NON-refundable