Purchase Application

Name*

Email*

City*

Address*

State*

Zip Code*

Phone number*

How did you hear about us?*

Please list other family members in this household:*

Please list other pets in your household and include their ages:*

Are your children okay around dogs and other animals?*

Can you assure that no one in the dwelling is allergic to dogs?*

YesNo

If you rent, are you prepared to always live in a pet friendly residence?*

YesNo

Do you have a fenced yard?*

YesNo

If not, how will you provide security for your puppy when it’s outside or when you're away?*

What are your work schedules? Is there someone home during the day or able to get home to potty-train a puppy?*

Where will this puppy spend the day and for how long?*

Where will this puppy spend the evening and night?*

Will this puppy have regular contact with it's family during the evening?*

YesNo

Where will this puppy sleep?*

What type of personality are you looking for in your dog?*

Please provide other information you think will help me get to know you:*

What sex are you interested in?*

MaleFemale

Would you consider a puppy of another sex if your preference is not available?*

YesNo

On a scale of 1 - 10 how important are the looks of the puppy? *

Along those same lines, are you looking for something specific? *

On a scale of 1-5, where are you on your search?*

If you get puppy or dog from another location, will you inform us that you would like to be removed from the wait list?*

YesNo

Are you aware that Dalmatians grow to be (approximately) 50lb dogs that shed (QUITE PROFUSELY)? *

YesNo

Are you willing to attend training classes with this dog, if needed?*

YesNo

Are you interested in providing a home for a deaf puppy and taking on their special needs?*

YesNo

What do you want a dog for?*

Do you agree that, if for some reason you are unable to care for this dog, I will be contacted about its relocation and will need to be actively involved in finding a suitable new home or have the dog returned to me?*

YesNo

Do you have a problem with a spay/neuter contract and limited AKC registration?*

YesNo

If Yes, why?*

Have you ever owned a Dalmatian before?*

YesNo

If No, what other breed of dog have you owned? *

Do you still own the dog(s) mentioned above?*

YesNo

If not, what happened to the dog(s)?*

In the past, have you had any significant difficulties with dogs you have owned? *

Have you ever had a puppy you needed to make sure was raised and trained to your household’s specifications?*

YesNo

Have you ever given up a dog to a shelter, pound, or rehomed a dog? If so, why?*

Who will have primary responsibility for the care of this puppy?*

Do all family members agree on the addition of a Dalmatian to the family?*

YesNo

If not, who is not in favor of getting a Dalmatian and why?*

Do you agree to register your puppy’s microchip as soon as possible?*

YesNo

Please provide the name, address, and phone number of your vet (or one that has worked with you in the [recent] past):*

Comments

Dalmatian Interest