Cottonwood Ranch Yorkies

First Name*
Last Name*
E-mail*
example@example.com
Address*

Street Address

Street Address Line 2

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Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
Cell Phone*

Area CodePhone Number
How did you hear about us?*
'Referral' or 'Other' please enter below:
Is this your first dog?*
Is this your first time raising a puppy?*
Do you have other pets in the home?*
Please list species breed and age of other pets:
If you have any other dogs in your home are they intact, spayed or neutered? Please list any/all below:
Type of housing?*
If 'Other' please explain:
If applicable does your landlord allow pets?
Do you have a fenced yard?*
How many adults in your home?*
Are all adults in the home in agreement to purchase a puppy?*
May we ask how old you are? I understand this might seem like an odd question to ask however our dogs and puppies may live upwards of 15+ years and we would like to ensure their furever home is forever.*
How many minor children in your home (under 18)?*
How many children are under the age of five (5) years old?*
Does anyone in the home have allergies to dogs?*
Have you or any one in the puppy’s future household ever been arrested, charged or convicted for animal cruelty or animal hoarding?*
I check records for each adult in your household.
Have you ever rehomed or taken your dog to a rescue/shelter? If yes please note the reason for rehoming.

How many hours will the puppy left alone due to work, errands etc.. on a daily basis?*
Where will the puppy be kept when left alone*
Where will the puppy spend most of its time?*
Where will the puppy sleep at night?*

Reason for wanting a puppy? Check all that apply*

Remember, pets are an investment of both your time and money. Can you afford to provide medical care, grooming, proper diet, proper shelter, proper training and exercise for your new pet?*
Will you be able to live with hair on your furniture, stains on your rugs and an animal that can be destructive at times?*
Are you wanting to join our reservation list and able to place the $200 non-refundable fee that is required to be added to our reservation list?*
Are you aware and able to place a $500 non-refundable deposit that is required to hold the puppy of your choice? ($300 if you have already placed your reservation list fee with us)*
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?
Please sign & click submit below.

You will receive a confirmation copy of your completed form to confirm that your application has been submitted. If you do not receive a copy please makes sure you have filled out the entire application and clicked SUBMIT below. Call if you require assistance. 623-202-3874

Cottonwood Ranch Yorkies reserves the right to refuse adoption to any client for any reason.

This application becomes part of our contract
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