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. A $200 deposit to hold your puppy will be collected after your application is approved, and will be deducted off the total price of the puppy.
Deposit type

CheckE-transferOther
Full Name*

First NameLast Name
Profession*
E-mail*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number - Home*

Area CodePhone Number
Phone Number - Cellular

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:*
Household Setting*

RuralSuburbanUrban
Do you have children at home?*

YesNo
Does Anyone in your household have allergies to animals?*

YesNo
If yes, please indicate type, severity and if medication is required to manage.
Have you owned a dog before?*

YesNo
Do you have any pets now?*

YesNo
What Gender are you looking for?*

MaleFemaleNo Preference
Do you have a veterinarian you plan to use?*

YesNo
Do you have a fenced yard?*

YesNoPartial
For the safety of your puppy, when not in an enclosed fence area, please keep your puppy on a leash at all times.
Will the puppy live indoors?*

YesNo
Do you work outside of the home?*

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
Do you understand the time and energy it takes to care for a puppy:*

YesNo
Will the puppy be picked up?*

YesNo
Would you like to have the puppy delivered?*

YesNo
Do you agree to contact My Daisy Doodles in the event you cannot keep your puppy?*

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*
The $ 200.00 deposit will be returned if your puppy requirements can’t be filled. Thank you for choosing your puppy from Daisy Doodles!
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