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Apply for a Puppy

Name_____________________________________________________________________________________________

Street Address___________________________________________________________________________________

Town, State, Zip__________________________________________________________________________________

Phone number___________________________________________________________________________________________

Email Address__________________________________________________________________________________________

Occupation:______________________________________________________________________________________

Allergies in family_______________________________________________________________________________

Children in family (ages):_______________________________________________________________________

Other pets at home/breed/gender:___________________________________________________________________________

Fenced Yard or dog park nearby?_______________________________________________________________

Number of hours you will spend with your pup daily __________________________________________

When working, where will your pup be?_______________________________________________________

Have you owned a dog before?______________ Do you want a male or female?_________________

Will this pup be a service/therapy dog or a pet?_____________________________________________

Do you prefer medium or standard size?___________ Do you want F-1 or F1-B?________________

Color preferred__________________________________________________________________________________

How were you referred to us?__________________________________________________________________

SIGNATURE____________________________________________________________DATE____________________

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