Puppy Placement Application

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Please fill out the application with complete and detailed information. Submitting this Puppy Placement Application certifies that the information provided is true and correct. Should any information be found false or incomplete, this application could be rendered null and void. A member of our family may contact you via phone or email for more information but further communication or the sale of a puppy is not guaranteed. This application is required prior to submitting a deposit in support of our efforts to make the best possible judgement of a healthy puppy to family pairing.

Email *

First Name *

First Name

Last Name *

Phone Number *

Spouse/Significant Others Name

First and Last name

Spouse/Significant Others Phone Number

Home Address (Street) *

Home Address (City, State & Zip Code) *

Will this location listed above be the primary dwelling place of the puppy? *

Yes

Other:

Required

Are you at least 18 years of age and able to enter a legal agreement? *

Yes

Required

Do you have children in your home or children that are frequent visitors? *

Yes

Required

Please list children, family and/or adults living in the home; to include names and ages. *

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