Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Have you ever owned a dog and been responsible for their care, training , etc?

Yes

No

Are you looking for :

Male

Female

No Preference

Is there a specific puppy you are interested in?

Yes

No

I am interested in: *

Limited AKC Registration (pet only)

Full AKC Registration (breeding and show rights)

Do you plan to breed this dog? *

Yes

No

I understand that Limited AKC Registration cannot be upgraded to Full AKC Registration at a later date. *

Yes

No

Do you own any other animals?

Yes

No

Type of dwelling?

House

Duplex

Apartment

Mobile Home

Other

Do you

Own

Rent

Live with parents

Other

Do you have a fenced in yard?

Yes

No

Will the puppy share a home with others besides yourself?

Yes

No

Spouse

Children

Other people

Other pets/animals

Where will the puppy spend most of its time?

Indoors with family

Indoors in a crate

Outdoors in an insulated doghouse

Outdoors with no doghouse

Will there be someone at home to supervise the puppy during the day?

Yes

No

On average, how long during the day will the puppy be on their own?

Hardly ever, someone will almost always be at home.

Less than 4 hours.

4-8 hours.

More than 8 hours.

I intend to take the puppy with me to work and/or most places I travel.

Are you confident that you can afford not only the cost of this puppy, but also the ongoing expense for upkeep and care such as adequate food, veterinary visits (both routine and emergency), and accessories (collars, leashes, toys, etc,)?

Yes

No