Puppy Application form

Puppy Application

The information contained in this application is used only for the purpose of placing a puppy and will not be used elsewhere.
Full Name*

First NameLast Name
Profession*
E-mail*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number - Mobile

Area CodePhone Number
Lifestyle:With these questions, we will be able to match the puppy better with its new home.
Do you live in a:*
RuralSuburbanUrban
YesNoOther
0 - 33 - 56 - 1010 - 1313 - 1515 - 1818+
YesNo
If yes, please indicate type, severity and if medication is required to manage.
YesNo
ToySmallMediumLargeGiant
YesNo
PetShowBreedWorkOtherOther
MaleFemaleNo Preference
Black and TanGoldNo Preference
YesNo
YesNoPartial
Tibetans need a safe, secure yard. They can jump fences of 6 foot quite easily and can easily chew through wood.
YesNo
YesNo
How many hours in a day would the puppy be left alone?
On average a puppy shouldn’t be alone more than 5 to 6 hrs. a day
YesNo
YesNo
YesNo
YesNo
Please indicate anything else that may help us with selecting the right puppy for you.
By sending this electronically, I acknowledge that I have completely read this questionnaire and comprehend it fully. I understand that applying does not ensure approval
Date*

MonthDayYear
Your name*
E-mail*
Should be Empty: