Puppy Application

Date:

Name

First

Last

Address

Please list City, State, and Zip Code too.

Phone

Email

Which puppy / breed are you interested in?

Do you own or rent your home?

If you rent, have you contacted your landowner to discuss having a puppy in your home?

How many people live in your home?

Please list each person’s name and age.

What is your occupation / work hours?

Where will the puppy spend most of his / her day?

Have you owned a dog before?

Do you have any other pets?

If so, please list all pets you have now (age, breed, gender).

breed If What

What is the primary purpose / event for this puppy:

Do you currently have a veterinarian?

If yes, please provide name and phone number.

Please provide 3 references, family / personal references with contact numbers:

Where did you hear about us?

Please list anything else you would like us to know about yourself or your family:

Purrfect Paws