Please fill out the form below and submit it to Nicker Barker Farm to help us evaluate the fit of our puppies with your family.
How did you hear about Nicker Barker Farm and our dogs?
We know someone who got a puppy from you
An advertisement with the AKC
An advertisement in the local newspaper
Referred by a veterinarian
We acquired a dog from you in the past
Have you or your family had a dog before?
What happened to your most recent dog?
Gave or sold to another
Dog passed away - natural cause
Dog passed away - accidental cause
Dog is still alive
What other animals do you have in your home?
How many children are in your home and what are their ages?
Who will be the primary care giver for the puppy?
If a child, include his/her age.
Is anyone in the family not in favor of adopting a puppy?
If you answered "yes" to the last question, who is not in favor of adopting a puppy?
Please describe the environment in which your puppy will be raised:
Plan to walk/job on leash
Have fenced yard
Will allow dog to run free
Have dog run
Will tie dog in yard
Dog will have roam of house
Will crate dog at night and when we are away
Will keep dog in restricted area of house
Do you plan to...
Train your dog
Hunt with your dog
Show your dog
Breed your dog
Train for therapy work
Do you agree to provide feedback and pictures to Nicker Barker Farm?
Do you have a preference for the puppy's sex?
Do you have a preference for the puppy's mother?
Do you have a preference for the timing?
Within the next year
Within the next few months
As soon as possible
Has to be immediate or we must look elsewhere
Any comments, questions, or concerns?
Please keep in mind that the order of receipt of a deposit will determine the order of the pick in any litter. After submitting, please call us at 814-364-1108 or email us at
to assure that we have received your form.
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