Puppy Application

Application & Questionnaire

This application is required to reserve one of our Am Staffs. The following questions assist us in helping select the right dog for your overall needs, goals and lifestyle. Incomplete or vague applications will not be considered. We reserve the right to deny individuals we feel may not be the proper fit for one of our puppies at this time. Thank you for your cooperation and understanding. We look forward to connecting with you and learning more about your family's puppy goals.
Name*
list all applicants and potential owners
Email*
Phone*

area code phone number
Age*
legal guardian required if under 18
Address*
Military*

Not MilitaryActiveGuard / ReserveVeteran
Housing*

HouseApartmentCondo / Townhouse
Do you own or rent?*

OwnRent
Does your neighborhood have a HOA?*

YesNo
Do you live in a flood zone?*

YesNo
Do you have a private fenced yard? What type of material and how tall is it?*
if no, how will you be exercising the dog
List all members of the household, including their ages.
please list name, relation and age
Do you own any other animals? If so, share some details about each.*
please list pet type, breed, sex, age and personality traits
Are your other animals spayed or neutered?*
if not, please explain
Current Veterinarian Information*
please list name, location and contact information
What made you choose this particular breed?*
Main Reason for Puppy Inquiry*

Pet / CompanionShow / BreedingSports / PerformanceTherapy / Service
How soon are you wanting to bring home a puppy?*

Now6 Months12 Months1-2 Years
Preferred Gender*

MaleFemaleEither / First Available
Preferred Color*

Red / FawnBrindleBlackBlue / Blue FawnAny / Not Picky
Do you want to crop your pup's ears?*

YesNoNot Sure
Preferred Transport*

Personal DeliveryPickup From BreederFlight NannyInternational Shipping
Where will the dog live and be kept during the day, at night and while you are away?*
please be detailed in your response
Do you work? How many hours on average will the dog be left alone? *
please share occupation and a typical work schedule
Please share any other helpful details about your family and overall lifestyle...*
this information helps us match your family with the right puppy
Do you plan to continue crate training?*

YesNo
Do you plan to vaccinate your puppy?*

YesNo
Do you plan to attend future training or handling classes?*

YesNo
What energy level are you expecting in an Am Staff?*

HighModerateLow
Do you have experience with this or a similar breed?*
please list any prior experience with bully breeds
Have you ever competed in dog sports or obtained a dog's championship?*
Have you ever bred or raised a litter of puppies?*
Are you interested in becoming a co-owner or guardian home?*

YesNoI'd Like More Info
Liberty Am Staffs breeds on a limited basis. Are you prepared to wait for the right puppy?*

YesNo
Have you ever re-homed or returned an animal purchased from a breeder?*
if so, please explain the circumstances
Have you ever surrendered an animal to a shelter, rescue or foster?*
if so, please explain the circumstances
Are all applicants prepared to offer a stable living environment and financial ability to properly care for a dog over the next 10-15 years?*

YesNo
Are you familiar with (BSL) Breed Specific Legislation?*

YesNoSomewhat
Are all members of the household prepared to handle potential breed traits such as dog aggression, selectiveness and prey drive?*

YesNo
Please list two non-related references.*
please list relation and best contact information
All applicants understand the difference between full and limited AKC registration.*

YesNo
All applicants have familiarized themselves with this breed's care and exercise requirements.*

YesNo
All household members agree to the addition of an American Staffordshire Terrier.*

YesNo
All applicants acknowledge our dogs are never to be resold or used for illegal purposes.*

YesNo
All applicants have answered these questions completely and truthfully.*

YesNo
Should be Empty:

Now create your own Jotform - It's free!Create your own Jotform

Application & Questionnaire