Puppy Questionnaire

Date*

Date

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.

Email*

example@example.com

Are you over the age of 18?*

Why are you interested in Pembroke Welsh Corgis?*

Who will be the caregivers for the new puppy?*

Please list ages of all children in the household:*

Do you currently own any other dogs and/or any other house pets? Please list: *

Are you a kennel?*

Where will the puppy spend the days and nights? *

Are you looking for a male or female?*

Do you have a preference in color?*

Have you met a Pembroke Welsh Corgi? *

Do you have a fenced yard?*

All puppies are sold on a Spay and Neuter contract and you will need to agree to sign a contract stating this. Please enter initials here: *

Are you aware Corgis shed ALOT, not just 2 times a year?*

Does anyone in the household suffer from allergies? *

Name, address and phone number of your vet:*

Our contract requires that you agree to return this dog or puppy at anytime if you can no longer keep it or care for it. You cannot resell the puppy. Do you agree to this, as it is part of our contract?*

Have you ever returned a pet to the breeder? If so, what were the circumstances? *

Have you ever taken a pet to a pound or shelter? If so, what were the circumstances? *

Do you understand the difference between a limited registration and a full registration?*

Adding a purebred AKC Pembroke Welsh Corgi to the family takes some great thought, and finding a responsible breeder, even more time consuming. We, as responsible breeders, put alot of time, money and love into every litter. This is why we ask for a questionnaire.

I hereby certify that all the information contained in this questionnaire is true and correct. This application is not an agreement to buy or sell a puppy but is a tool to aid me, as the breeder, in the placement of a puppy. This is not a sale contract for a puppy.

Signature

Date