Puppy Purchase Form

At Ease Acres Puppy Purchase Application:

Thank you for considering us as the breeder for your corgi puppy! We are committed to helping you find the perfect puppy for your family.
Our puppy prices range, starting at $1,800.00 and go up.

To ensure a successful pairing with our pups we kindly ask that you take a few moments to answer the following questions about your lifestyle and home enviornment. All information will be kept strictly confidential and used only by us to assist you in finding the best match.

** Please note that the submission of this application DOES NOT guarantee availability of a puppy.  We reserve the right to screen all applications to ensure the best possible outcome for both our puppies and your family. We require a deposit to be placed on our waiting list. A spot on our waiting list is not considered reserved until a deposit is received and a confirmation has been sent by us. **

Thank you for your cooperating and interest in our dogs. We look forward to helping you find your new furry companion!
Are you applying for a Currently Available Puppy? If so, which puppy?
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
E-mail*
example@example.com
How did you hear about us?*
If you were referred by a past At Ease Acres puppy buyer, please list their name(s).
Age and Gender of all household members.
Preferred puppy gender and color (if applicable)
Have you had any dogs before?*
Please list all other pets that you have and their ages.*
Do you have experience with Corgis or herding breeds?*
Will your puppy be receiving obedience training?*
Do you agree that the puppy you are applying for will come with Limited Rights (Not To Be Used For Breeding Purposes) and do you agree to sign a spay/neuter contract?*

YesNo
Which of the following best describes your residence? Please check all that apply.*

Has a fenced in outdoor spaceDoes not have a fenced in outdoor spaceHouse/DuplexApartment/Condo
Does your property have pet restrictions?*

YesNo
Who will be the primary caregiver for the puppy?*
Have you considered how your puppy will be cared for when you are away (vacation, work trip, etc.)
How long will the puppy be alone or confined during the day.*
Will you be crate training?*

YesNo
List all current pets, including age, type of pet/breed and if they are spayed or neutered.
Have you ever returned a pet for any reason?
Is there anything more you would like to share with us?

Please provide your veterinarian's contact information:*

	Full Name	Address	Contact Number
1

Please provide 3 personal references: (Non-Family Only)*

	Full Name	Address	Contact Number	Relationship
1
2
3

Should be Empty:

At Ease Acres Puppy Purchase Application: