Puppy application form

APPLICANT INFO AND PREFERENCES
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Alternative Number
Please enter a valid phone number.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How did you hear about Copper State Yorkies?
If referred by someone, who may we thank?
Is this your first dog?
Is this your first time raising a puppy?
Why are you looking to find a new puppy?
Do you have any specifics in what you are looking for in a puppy? Color? Gender? Or, do we currently have a puppy that you would love to bring home?
Do you have other pets? Please list all animals and ages. (ie, other dogs, cats, birds...etc.)
Type of housing do you live in?
Do you own or rent this home?
If applicable, does your landlord allow pets?
Do you have a fenced in yard?
How many adults in your home?
Age of all adults in the home?
Are all adults in agreement to have a puppy in the home?
How many children in your home?
Age of all children in the home?
Is anyone in the home allergic to dogs/animals?
Has anyone in the household been arrested, charged or convicted for animal cruelty or animal hoarding? If so, please explain the situation and the outcome.
Have you or anyone in the home ever rehomed a pet or taken your pet to an animal rescue/shelter? If so, please explain the reason.
Is there any other info you think we should know or any question you might have?