Puppy Application

Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Have you or anyone in your household ever been arrested, charged, or convicted of animal cruelty or animal hoarding? *

Yes

No

Is anyone in the home allergic to dogs? *

Yes

No

Do you prefer... *

Boy.

Girl.

I want the puppy who is the best match for me, regardless of gender.

Is this puppy going to be a surprise gift for someone? *

Yes

No

How will you pick up your puppy? *

We are located in Sumterville, Florida. About an hour drive from either of the Orlando airports, the Tampa airport, or the Clearwater/St Pete airport. You must pick up your puppy.

Fly in

Drive in

Is this your first puppy/dog? *

Yes

No

What do you plan on doing with your dog? *

Pet/Companion

Service Dog

Therapy Dog

Competition

Other

Are you interested in picking up your puppy at: *

8 weeks old

12 weeks old (after 4 week board & train)

16 weeks old (after 8 week board & train)

6 months old (after 4 month board & train)

1 year old (after 10 month board & train)

2 years old (after 22 month board & train)

Custom board & train

Will your dog be an inside dog or outside dog? *

Inside

Outside

Do you *

Own

Rent

If you rent, do you have your landlord’s written permission to own a dog?

Yes

No

Do you live in a *

House

Apartment

Condo

Other

Do you have a yard *

Yes, it is open

Yes, it is fenced

No

Do you have a pool *

Yes

No

Veterinarian Clinic Name

First Name

Last Name

Veterinarian Clinic Phone

(###)

###

####

Emergency Contact Name

First Name

Last Name

Emergency Contact Phone

(###)

###

####

Are you a disabled veteran applying for our Warrior Program?

Yes

No