C*S*Ta Havanese Application

We hope you will agree that the welfare of each C*S*Ta Havanese puppy is our foremost consideration in home placement.

Charlene Edwards . cme3320@aol.com or call 239-821-0699

Name*

Date*

Date

Address*

Address

Street Address Line 2

CityState

Zip

Home Phone*

Work Phone

Cell Phone*

E Mail*

example@example.com

1. Why did you choose the Havanese breed?*

2. Have you ever seen a Havanese, played with one or held one in person?*

3. How many people live in your home?*

How many children, and what are their ages?*

4. When would you want your new puppy (month and year)?*

5. Describe the personality you would love your new puppy to have:*

6. Do you prefer a male or a female?*

7. What do you expect the activity level of this breed to be?*

8. Are you aware of the grooming required with a full coated dog?*

9. Who will be the primary care giver?*

Is anyone home during the day? *

10. Where will the puppy be kept during the day?*

Where will the puppy be kept at night?*

11. How many hours a day will the puppy be left alone?*

Will there be someone to feed and exercise the puppy during the day?*

12. Have you ever owned a dog before? Please describe*

13. Do you have any other pets? Please list*

14. Do you have a fenced in area for the safety of your puppy? *

Have you ever house-broken a puppy?*

15. Will you be attending any training classes for your puppy? Please describe:*

16. Have you ever had to give up a pet in the past (i.e. surrender to a humane society, return to it's breeder, or resell)?*

17. Please provide one personal reference, including name, address and phone number*

18. Please provide the name of your veterinarian, including address and phone number*

Thank you for taking the time to fill out our application!