EAGLE VALLEY BEAUCERONS
Puppy Questionnaire
Your Contact Information
First Name
*
Last Name
*
E-mail
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
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Country
Phone Number
*
-
Area Code
Phone Number
Cell Phone
*
-
Area Code
Phone Number
Puppy Preference
Color Preference
*
Please Select
Any color
Black/Rust
Harlequin
Gender Preference
*
Please Select
Male
Female
Either Gender
Do you prefer cropped ears or natural?(Additional $350 for crop)
Cropped
Natural
Undecided
Are you willing to consider a puppy that does not match your stated preferences above?
*
Please Select
Yes, I'd love a Beauceron no matter what
Maybe. I'll think about it, but can't commit now.
No, we need to stick to our 1st/2nd preferences
About Puppy's New Family
What are you looking for in a new puppy?
*
Is this your first dog?
*
Please Select
Yes
No
First time as an adult
Is this your first time raising a puppy?
*
Please Select
Yes
No
No, but it's been a while!
Do you have other pets in the home?
*
Please Select
Yes
No
Please list species breed and age of other pets:
Do you already have a veterinarian?
Please Select
Yes
No
I need a recommendation
If yes, who?
What do you plan on doing with your dog? Checking a box with ** means you plan on TITLING/COMPETING within that venue.
*
Yes
No
Haven't decided yet
Conformation **
Rally/
Obedience **
Performance:
Agility,
Dock Diving,
Fly Ball, Etc. **
Sport:
IGP,
French Ring,
Mondio, Etc. **
Herding **
Family Pet/
Companion
Future Breeding Candidate
Please tell us a little about where puppy will live as a puppy (we know circumstances change).
Type of housing
*
Please Select
Apartment
Condo
Single Family Residence
Other
Do you:
*
Please Select
Own this home
Rent this home
Rent-to-Own
Other: Staying with family
If other, please explain:
Does your landlord allow pets?
Please Select
Yes
No
Not sure
I'm sure we can work something out
Do you have a fenced yard or secure kennel?
*
Please Select
Yes
No
Not yet, but we're getting one
No, but we have a dog play area
Is any head of household currently serving our country in the US Military?
*
Please Select
Yes
No
How many adults in your home?
*
Please Select
1
2
3 or more
How many minor children in your home?
*
Please Select
0
1
2
3 or more
How many children are under the age of two (2) years old?
Please Select
All
None
1
2
3 or more
Are all adults in the home in agreement to purchase a puppy?
*
Please Select
Yes
No
Does anyone in the home have allergies to dogs?
*
Please Select
Yes
No
Where will the puppy spend most of its time?
*
How will the puppy be trained?
*
Please Select
We will probably train the pup ourselves
Puppy classes
Professional trainer
Are you willing to crate train your puppy?
*
Please Select
Yes
No
Not sure yet
I need more information on this
Will your puppy be an inside or outside dog?
*
Please Select
Mostly indoors
Mostly outdoors
Both
How many hours will the puppy left alone (without a potty break) each day?
*
Please Select
Less than 4
4 to 9 hours
9 to 12 hours
More than 12 hours
Is this puppy being purchased as a surprise or gift for anyone?
*
Please Select
No
Yes
Have you or any one in the puppy’s future household ever been arrested, charged or convicted for animal cruelty or animal hoarding?
*
Please Select
No
Yes, but it was a minor conviction and progress has been made
Yes
I check records for each adult in your household.
Ownership Commitment
This litter will be available to go home on a specified date. Will you be able to take this puppy home on or within 2-3 days of this date?
*
Please Select
Yes
No, please contact me so we can make other arrangements
Will you be able to pick up your puppy in person in Sanders, Kentucky?
*
Please Select
Yes
No
Maybe
Are you planning on needing to arrange ground or air transport for your puppy?
*
Please Select
Yes
No
Maybe
Do you agree to give us follow-up reports and photos from time to time?
*
Please Select
Yes
No
Do you agree to contact us in the case that you need to re-home this puppy for whatever reason?
*
Please Select
Yes
No
Do you understand that puppies sold as companions only are placed on AKC Limited Registration? This means that the dog is eligible to be registered, however, none of the offspring are eligible for registration. A dog with Limited Registration, as well as a spayed/neutered dog can compete in all AKC events except in the Conformation (Breed) ring.
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Yes
No
Are you willing to take your puppy to a basic obedience classes or if able, train at home to insure that you have a well-mannered, enjoyable companion and ideally complete the AKC CGC evaluation and submit the form to AKC for recording? This is usually an additional $25 fee due and payable to AKC at the time the form is submitted.
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Yes
No
When this puppy is purchased exclusively as a family companion, do you agree to have it spayed (females) after 18 months of age or no sooner than the first heat cycle or neutered (males) no earlier than 24 months of age and submit a Veterinarian Certificate to the Breeder as proof of surgery for their records?
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Yes
No
We no longer sell puppies on full registration unless to an established breeder. If you are looking for a breeding or show prospect we can provide referrals.
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I Understand
I Am A Breeder
I Need A Referral
Do you understand the price of the puppy is $3000 and includes AKC registration, microchip, all age appropriate vaccinations/deworming, DNA Profile, ear crop ($350 additional unless agreed to leave natural) before leaving breeder’s possession and health certificate for domestic travel. There is no price difference for Limited or Full Registration and the price of airline shipping is at the expense of the puppy buyer. Personal pickup is welcome and hand delivery may be available to be arranged at buyer’s expense.
*
Yes
No
Please provide any other relevant information you feel would assist us in placing a puppy in your home:
Do you have any other questions for us you’d like us to note?
Your Signature
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