Personal Information
Full Name
*
First Name
Last Name
Address Line 1
*
Address Line 2
City
*
Phone 1
*
-
Area Code
Phone Number
E-mail
*
How did you hear about us?
Please Select
Referral
Internet Search
Internet Advertisement
Internet Blog
Printed Publication
Social Media
Other
Puppy request Information
Date range for desired adoption
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2028
2027
2026
2025
2024
2023
Year
Gender requested?
Male
Female
Color requested
Family Information
number of kids, adults
How busy is your family?
Busy
very busy
Not busy
retired
Other
Where will your dog stay during holidays?
Where will your dog stay during the day?
Loose in the house
gated indoor area
Crated inside
garage
Fenced kennel/dog run
Fenced yard
Loose outside
Other
Where will your dog stay during the night?
Loose in the house
gated indoor area
Crated inside
garage
Fenced kennel/dog run
Fenced yard
Loose outside
Other
How many hours per day will your dog be left alone?
What type of home do you live in?
House
Condo with outdoor space
Apartment
Acreage
Other
Have you had dogs before?
Have you ever been convicted of animal cruelty or neglect?
*
Yes
No
Have you ever given away, surrendered a pet?
*
Yes
No
If yes, what happened?
How many hours excersize can you give your dog per day?
What would you enjoy doing with your dog?
on leash walking
jogging
Hiking
off leash parks
Other
Are there any other pets in your household??
Yes
No
If yes, please list breed, age, sex, neutered/spayed
Do you feel financially prepared to care for a French Bulldog?
Yes
No
Under what circumstances would you rehome your dog?
Agression
Moving
New baby
Too costly
Medical reasons
Not enough time
Behaviour problem
we are willing to work with any and all circumstances with our new pet, providing a forever home
Other
Please provide any additional information or questions
Falsified information will lead to automatic rejection. Black Creek Bulldogs reserves the right to refuse any applicant. I understand that it is my responsibility to make a carefully thought out decision to ensure a loving, lasting relationship with an animal friend.
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