Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Do you have a gender preference? *

Male

Female

Either

Do you plan to take puppy to obedience classes? *

yes

no

Will this be your first puppy? *

yes

no

Do you have young children in your home? *

yes

no

Do you have other dogs or pets in your home? *

yes

no

What are your current living conditions? (Please check all that apply.) *

I/ We Rent

I/ We Own

I/ We live in a house

I/We live in an apartment

I/ We live in a condominium

Do you have a fenced in yard? *

yes

no

If for reason, at any time you are unable to keep your dog, we require you to contact us immediately. We will either ask you to return the dog to us or will assist in re-homing him/her for you. Do you agree to this re-homing policy? *

yes

no