Fieldstone Farm & Kennel New Puppy Application Form 2019

Fieldstone Farm & Kennel Molly Orion x Leonidas Summer 2023 Retirement Litter Reservation Application

This litter will be a Molly Orion x Leonidas standard golden litter.
Terms

Placing a non-refundable holding fee on a future litter holds your place in line to pick a puppy. Only those with an approved Puppy Application can place a holding fee. Holding fees are $500.00 and that amount will go toward total purchase price of puppy. Holding fees are non-refundable and will reserve your place in line once the puppies arrive. Make sure you are committed and ready for a puppy when placing a hold because it turns others away and it will for no reason be returned. If there is not a puppy in the litter you want and this is determined and communicated in the first week, you can move your holding fee to the next available litter. Due to additional OFA Certifications, prices are currently $1,000 for males and $1,800 for females with limited AKC registrations (no breeding rights), to approved homes only. Dates for future planned litters are tentative and subject to change. We always make sure the parents are healthy and sound prior to breeding and depending on heat cycles, this may occur sooner or later than stated above.
Full Name*

First NameLast Name
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
Why do you want a Golden Retriever?
MaleFemaleNo Preference (you are comfortable with us placing you on either the male or female list)
Please describe the type of dog you are looking for (personality trait/temperament). We always want to make sure we have the best fit for our foster homes.
Do you live in a:*
OwnRentLive with ParentsOther
If Renting: Please indicate landlord contact information
RuralSuburbanUrban
Busy/NoisyModerate Comings/GoingsQuiet with Occasional Guests
YesNoPartial
Please List all People Living in the Household (Include Name, Relationship, Gender and Age)*
YesNo
Do you currently have any other animals living with you? If so, what kind/breed and age? Have they been around other dogs before?*
Have you owned a dog before? If so, do you currently own it or please tell us why you no longer own your dog.
Will there be someone home with the puppy during the day? If not, where will your puppy be during the day?
How many hours a day will the puppy (new puppy through 5 months) be left alone? Puppies can only be kenneled for 2-3 hours when they first come home.
What are you plans to exercise your puppy? Please list any parks near by or trails, how many walks a day, approximate length, and activities such as agility.
Where will your puppy sleep at night?
YesNo
Vet Reference: Full Name (If you have not used a Vet in the past, please list the name of the Vet that you plan to use with your puppy).*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Reference #1: Full Name*

First NameLast Name
Relation to applicant(s):
E-mail
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Reference #2: Full Name*

First NameLast Name
Relation to applicant(s):
E-mail
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
YesNo
YesNo
YesNo
YesNo
YesNo
How did you hear about Fieldstone Farm & Kennel?
By signing and sending this electronically, I acknowledge that I have completely read this questionnaire and comprehend it fully.

I understand that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application can result in the forfeiture of any Fieldstone Farm & Kennel animal purchased by me.

I certify that the above information is correct, and I understand that the information will be verified.

I agree to have Fieldstone Farm & Kennel complete reference call checks and, if requested, to conduct a home visit inspection to be able to approve my new puppy application.

I agree that if I'm unable to care for the dog(s) anymore that I will return the dog(s) to Fieldstone Farm & Kennel.
Signature (just sign on the line using your finger, computer mouse, or stylus).

Clear
Date

MonthDayYear
Your name*
E-mail*
WOULD YOU LIKE TO MAKE A DEPOSIT OR BE ADDED TO THE WAITING LIST? The deposit will be placed towards your total fee and will guarantee you a place in line for a puppy. (I understand that if I choose to make a deposit, it is non-refundable. I also understand that I am not guaranteed a puppy. If, after application review and reference checks, we determine that one of our puppies is not the right fit for you, we will refund your deposit amount.) If you are added to the waiting list, we will reach out to you after all those with deposits if puppies remain available.*

Yes, I would like to make a deposit. This guarantees me the next available choice of my preferred sex. Please indicate how you wish to pay in the last box.No, I do not wish to make a deposit but I would like to be added to the waiting list. I understand that this places me on the litter list, but that those who have made deposits will have first choice of puppies.
Check. We will email you the mailing address.Cash. We will contact you to make arrangements.PayPal. We will send you an invoice. There is a fee for using Paypal.Venmo. We will message you our QR code. There is a fee for using Venmo.Other
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New Puppy Deposit $500$514.50
Puppy Deposit

Subtotal $0.00Tax $0.00Total $0.00
Payment Methods

Choose from one of the PayPal options to make your payment.
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