Jigsaw Jack Russell Puppy Application:
Please fill out completely
Puppies are $2500
Puppies are DM, SCA, PLL & NNA clear, parents are CERF tested yearly
Full Name:
First Name
Last Name
Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number:
-
Area Code
Phone Number
E-mail
example@example.com
How did you hear about us?
Web Search
Facebook
Instagram
Referral
Other (please specify)
What made you choose a jack russell terrier?
Is this your first time owning a pet?
Yes
No
Do you currently have other pets in your home? Please tell us how many and what kind(s)?
Do you have children? If so, what are their ages.
Are you looking to add a male or female to your family?
Male
Female
No Preference
Whichever becomes available first
What age Jack Russell would you be interested in?
8 week old puppy
Older puppy (up to 1 year old)
Young adult (Age 1 - 4)
Older adult (Age 5 and up)
Are you looking for a family pet that will be spayed/neutered or are you looking for a show quality pup?
Family Pet
Show quality
Do you plan on staying/neutering? If not, why?
Are you aware of the three different coat types? (Smooth, Broken and Rough)
Yes
No
When are you looking to add a jack russell to your family?
The soonest that one becomes available
2-4 months
4-6 months
6 months to a year
1 year or more
For the puppy's exercise, how active would you consider your family to be?
A little active
Moderately active
Very active
How will your puppy get their needed exercise?
Do you have a safe, fenced in yard? What type of fencing is it?
If employed, do you work at home or out of the home?
At home
Out of the home
How many hours would your pet be left home alone?
# of hours
In a brief paragraph tell us about your past pets..... How long did they live? What was the cause of death? Were any taken to a shelter or rescue? If yes, what was/were the reason?
Do you have any goals/interests for your puppy? Showing, Service, Therapy, Rescue etc.
Are you aware that we require our puppies to be returned to us if you are unable to keep them?
Yes
No
Are you aware that deposits are non-refundable
Yes
Can you commit to 14 or more years to feeding, caring for, and grooming your jack russell?
Yes
No
Please tell us any additional information we might need to know and/or ask us any questions
Submit Form
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