Customer Details:
DBK’s Puppy Application
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Format: (000) 000-0000.
E-mail
example@example.com
How did you hear about us?
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Have you ever owned this breed of Dog?
*
Yes
No
Fostered
A mix
Your choice of puppy would be? (Choose all that apply)
Male
Female
Mottled
Speckled
Blue
Red
full mask
1/2 mask
Plain face
Australian cattle dog
Belgian Malinois
Fawn
Fawn Sable
Mahogany
Red
Red Sable
What age puppy/Dog would you be interested in?
Puppy- 8-12weeks
Puppy- 3-6months
Puppy- 7-11months
Young adult- 12-18months
Adult- 2+ years
Which are you interested in?
AKC Full Registration
AKC Limited Registration
Are you interested in a particular litter? Or pairing?
Yes
No
If yes- First choice Dam
First choice Sire
Second choice Dam
Second choice Sire
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What are your plans for the puppy/Dog? (Ex. work, show, agility, obedience, companion,etc.)
*
Do you own or rent your home?
*
Own
Rent
Other
Do you have a Veterinarian, if so please provide address, and contact information below.
If you rent, do you have approval from your landlord to bring in a new puppy/Dog?
Yes
No
If you rent, a signed letter from your landlord stating that dogs are permitted on their property must be received before a puppy is placed with you. The breeder reserves the right to contact the landlord before placing any puppy. Please provide your landlord's contact information:
If you rent, is it a
House
apartment
Condo
Other
If you own do you,
Have a fenced in yard
have a Farm
Acreage
If you rent or do not have a fenced yard or farm environment, how do you plan to exercise and keep your Puppy/Dog busy and mentally challenged?
*
Who will primarily be responsible for this puppy’s care?
Have you or anyone in your household ever been charged with animal cruelty or had any animal taken away from you or any member or your household for suspicion of animal cruelty? If yes, please explain.
*
Do you have children? Ages?
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Will puppy/Dog be primarily kept:
*
Inside
Off ground kennel
ground kennel
inside & out
Other
Do you have other pets or animals? If so what kind?
Does everyone in your home want a puppy/Dog?
Yes
No
In the event of emergency (e.g., hospitalization, natural disaster, etc), who would take care of your puppy/dog?
Have you crate trained a puppy/dog before?
If you were to move, what would happen to your puppy/dog?
Are you willing to be responsible for this puppy/dog for the next 12 years or more?
Yes
No
Maybe
You do understand that if said puppy/Dog, at anytime in it’s lifetime, cannot be kept and/or properly cared for, that you will agree to return to me, the original breeder, at no expense to the breeder, and puppy/dog will be assessed and kept, or placed, into a properly suited home.
*
I Agree
I do not agree
Once a deposit is placed, you do understand that this is NON-REFUNDABLE?And to be used towards a puppy purchase WITHIN 12 months?
Yes
No
Do you agree that you will not Give away the puppy/dog?
*
Yes
No
Do you agree to NOT rehome the Puppy/dog to a unknown person without my knowledge?
*
Yes
No
By initialing here, you agree this is your applicant signature and are in completeunderstanding of all above listed questions, statements and all literature provided.
*
Submit
Should be Empty: