Please fill out if you're interested in one of our puppies.



If interested in an available dog please provide its name

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Please tell us about yourself.

Full Name (*)

Please type your full name.
Address (*)

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City (*)

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State (*)

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Zipcode (*)

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E-mail (*)

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Primary Phone (*)

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What is your marital status? (*)

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Your Occupation (*)

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Your Employer's Name (*)

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Does your occupation require you to travel? (*)

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Please tell us about your family.

Spouse's Name

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Spouse's Occupation

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Spouse Employer's Name

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Number of Children at Home (*)

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Name. Gender and Ages of children living at home (*)

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Please tell us about your home.

Describe Your Home (*)

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Do you have deed restrictions about pets? (*)

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Do you have a fully fenced yard? (*)

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Do you have a swimming pool? (*)

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Do you have any other pets in the household now? (*)

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Are you willing to puppy proof you house and yard? (*)

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Tell us about your dog experience.

Have you ever had a dog before and if yes what kind, and how long did you have it? (*)

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Are you willing to do the amount of brushing and combing required to keep it clean and free of mats? (*)

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Are you willing to spend the time and money to care for them properly? (*)



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Do you agree to contact me should not be able to keep this dog? (*)



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Are you willing to purchase a crate and use it until said puppy is housebroken? (*)



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If you purchase a puppy do you agree to have this dog spayed or neutered? (*)

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Tell us about your puppy preferences.

What puppy gender would you prefer? (*)

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Would you consider a puppy of the opposite sex? (*)

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Please provide two character references we may contact.

Please give two references: Name, address, and phone number. (*)

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How should we contact you? (*)


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