Puppy Application

First and Last Name(required)

House Address Number (required)

Street(required)

City(required)

State(required)

Zip Code(required)

Phone(required)

Email(required)

What are their names and ages?(required)

What are their ages?

Who will be the primary caregiver? (please provide their name and age)(required)

How many hours will the dog be home alone?(required)

1-3 4-6 7-9 More than 10

Will there be someone who can exercise the dog during the day?(required)

Yes, an adult in our home will be home for at least half of the work day. Yes, an adult in our home can stop in during lunch time. Yes, someone outside of our household can stop in during the day. Yes, I will just use Doggy Daycare on long days at work. No.

Have you ever had a dog before?(required)

Yes No

If yes, please list the breeds that you have owned in the past and/or currently own.

If yes, do you still have the dog? If not, please explain what happened.

Do you now your home or rent?(required)

I own my home. I own my condo. I rent a house and pets are permitted. I rent a house and pets are not permitted. I rent an apartment and pets are permitted. I rent an apartment and pets are not permitted.

If you rent, please provide your landlord's name and contact information.

Do you have a fenced in yard?(required)

I have a fully enclosed tactile fence. I have a partially enclosed tactile fence. I have an invisible fence. I do not have a fence, but can put in a fully enclosed tactile fence if need be. I do not have a fence, but can put in an invisible fence if need be. I do not have a fence.

Do you have any other animals? If so, pleas describe their species, spay/neutered status, personality, and age.(required)

Why did you choose the Dalmatian breed?(required)

have you ever returned a pet to a breeder?(required)

Yes No

Have you ever given a pet away?(required)

Yes No

Have you ever turned a pet over to a shelter?(required)

Yes No

If you answered yes to any of the three questions above, please explain the situation.

Where did you hear about us?(required)

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