Name
*
First Name
Last Name
Address
*
Address line 1
Address line 2
Town
County
Post Code
Email
*
Mobile number
*
Alternative contact number
*
When, approximately, would you like a puppy?
*
First Choice of Colour
*
Black
Yellow
Chocolate
No preference
Second Choice of Colour
*
First choice only
Black
Yellow
Chocolate
No preference
Preferred Gender
*
Male
Female
No preference
For what purpose(s) would you like the puppy (you may select more than one)
*
Pet
Showing
Breeding
Gundog
Other (please give details below)
Description of 'other' purpose
*
Is there normally somebody at home in the daytime?
*
Yes
No
If you answered 'no', please describe your plans for the puppy's daytime care.
*
Do you have your own private garden, ie for your sole use?
*
Yes
No
If you answered 'no', please describe your outdoor space
*
Is your garden fully-fenced?
*
Yes
No
If you answered 'no', please describe your environment.
*
Are there other dogs in the home?
*
Yes
No
Please give details of other dogs
Please give breed and gender
Have you bought a puppy/adult from us previously?
*
No
Yes, bought as puppy
Yes, rehomed adult
Please give details of dogs you have previously bought/rehomed from us
*
Please give approximate date(s), eg yellow dog - 2010
Please give here any additional information you feel would be helpful.
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