Utah Corgi's Puppy Application
Please fill out all fields
Full Name
First Name
Middle Name
Last Name
Birth Date
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
example@example.com
Mobile Number
-
Area Code
Phone Number
Where did you hear about us?
Facebook
Instagram
Web Search
From a Friend
Other
Is this your first time owning a Pet?
Yes
No
Does anyone in your home suffer from allergies?
Yes, Severe
Yes, Moderate
Yes, Mild
No
Do you have other pets living in your home at this time? If yes, Please specify which types of pets and how many.
Would you prefer to have a male or a female Corgi?
Male
Female
No Preference
Whichever becomes available first
When are you hoping to add a Corgi to your family?
As soon as possible
2-4 months
4-6 months
6-12 months
1 year or longer
How will you make sure to get your puppy enough exercise?
Where will your puppy be sleeping?
Do you have a safe environment for your puppy to stay? How big is it?
What do you plan to do with your puppy if you move?
If at any time you can no longer take care of your puppy, what do you plan to do with him/her?
Are you aware that we require our puppies to be returned to us if you are unable to keep them?
Yes
Are you aware that deposits are non-refundable?
Yes
Are you willing to commit to 12 or more years of caring for your Corgi?
Yes
No
What is your preferred way of contact?
Voice Call
Email
Text Message
What is the best time to contact you? (Mountain Standard time zone)
Mornings (7 am - noon)
Afternoons (Noon - 5 pm)
Evenings (5 pm - 8 pm)
Call Anytime
Would you like to include professional obedience training with your puppy?
Yes, 2 weeks $1,200
Yes, 4 weeks $2,400
Yes, 8 weeks $4,800
No Thanks, I will do it
How do you plan to get your puppy home (We are located in the Salt Lake Valley area and We can meet you anywhere in the Salt Lake Valley area (on the planned date for your puppy pickup) free of charge)?
I will fly into Salt Lake City International Airport
I will drive to pick up my puppy
I would like to schedule a flight nanny (for an additional fee)
I'm not sure yet, I will let you know ASAP
Please tell us any additional information we need to know.
Submit Application
Clear Fields
Should be Empty: