Puppy Application Form

The information contained in this application is used only for the purpose of placing a puppy and will not be used elsewhere. A non-refundable $500 deposit to hold your specific puppy will be collected after your application is approved, but not until the litter is born and we know how many we have. Completion of this application is not a commitment to purchasing a puppy or placing a deposit. After the puppies have arrived you will be contacted (if approved) and if we have a puppy that fits your request. At that point, you can place a deposit to hold your puppy. The deposit will be deducted off of the total price of the puppy. Deposits are non-refundable but may be transferred to a future litter.
Full Name*

First NameLast Name
E-mail*
Address*

Street Address

Street Address Line 2

CityState / Province

Country
Phone Number*

Area CodePhone Number
Preferred method of contact:

TextEmail
What is your time frame for bringing your new puppy home?
Do you have children at home?*

YesNo
Have you ever raised a puppy before?

YesNo
Have you owned a dog before?*

YesNo
Do you have any pets now?*

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

YesNo
Do you understand that a puppy is a long term commitment and that puppies have a lot of energy and require training and patience to raise them to be the best that they can be?*

Yes
We love the occasional "pupdate" and seeing photos of our puppies as they grow. Would you be willing to give us an update/photo every once in a while?

YESNO
How did you hear about us?blank*
Do you agree to contact Millie & Co. in the event you cannot keep your puppy at any point in time?*

YesNo
Have you ever surrendered a pet before?*

YesNo
If yes, for what reason?
blank
Do you agree never to surrender your dog to a shelter or rescue? Instead, in the event your dog needs re-homing, you will notify breeder who will either take the dog back/take responsibility for re-homing, or work together to find them a new, suitable home?*

Yes
What Gender are you looking for?*

MaleFemaleNo Preference
Preferred coat color?*

PhantomPhantom MerleChocolate PhantomChocolate Phantom MerleRed/CreamParti (white coat with patches of any colors mentioned aboveNO PREFERENCE
Is this dog going to be a pet/companion (strict spay/neuter contract) or do you need full AKC rights?*

Pet/CompanionFull AKC
We prioritize pet homes for our puppies, however Full AKC/Breeding rights are granted occasionally to select programs. If wanting AKC Breeding rights, please tell us about your program along with your website link, give us as much information as possible ;-)
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.
Please describe your home environment in which your puppy will be raised. Include if you have children, other dogs or pets, and your work schedule and plans for puppy care while you are away.
Will the puppy live indoors?*

YesNo
How many hours in a day would the puppy be left alone?
Would you like to have the puppy delivered? (Our puppies can fly in cabin with a flight nanny, to any major airport in the USA.)*

YesNo
Will the puppy be picked up from us?*

YesNo
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*
Signature

Clear
The $ 500.00 deposit is non-refundable but may be transferred to a future litter.
Should be Empty: