Puppy Application Form

Puppy Application

The information contained in this application is used only for the purpose of placing a puppy and will not be used elsewhere.
Full Name*

First NameLast Name
Phone Number *

Area CodePhone Number
E-mail*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Lifestyle:

With these questions, we will be able to match the puppy better with its new home.
Do you live in a:*
Do you own your home or is it a rental house?
Household Setting*

RuralSuburbanUrban
Do you have a fenced yard?*

YesNoPartial
Do you have children at home?*

YesNo
If children are in the home, what are their ages?
Does Anyone in your household have allergies to animals?*

YesNo
If yes, please indicate type, severity and if medication is required to manage.
Does anyone in the household have a fear of dogs?
Do you have any health conditions/disability that may limit your ability to exercise a dog?
Do you understand the time and energy it takes to care for a puppy:*

YesNo
For the safety of your puppy, when not in an enclosed fence area, please keep your puppy on a leash at all times.
Will the puppy sleep inside the home and be allowed inside throughout adulthood?*

YesNo
Profession*
Do you work outside of the home?*

YesNo
How many hours in a day would the puppy be left alone?
On average a puppy shouldn’t be alone more than 5 to 6 hours a day
Have you owned a dog before?*

YesNo
If so, what breed and how long ago?
Do you have any pets now?*

YesNo
If you currently have pets in your home list type, age, sex and breed.
Have you researched Golden Retrievers?
What Gender are you looking for?*

MaleFemaleNo Preference
Do you plan to spay or neuter your puppy?
Do you plan to take your puppy to obedience classes?

YesNo
Do you plan to insure your puppy?
Do you have a veterinarian you plan to use?*

YesNo
Name of veterinarian must be communicated to Lone Rock Golden Retrievers prior to picking puppy up.
Are you aware of the costs associated with keeping a dog? Veterinarian care/Grooming/Training Expenses?
Please indicate anything else that may help us with selecting the right puppy for you. Hobbies, Interests, Activity Level, etc.
Do you agree to contact Lone Rock Golden Retrievers in the event you cannot keep your puppy?*

YesNo
By sending this electronically, I acknowledge that I have completely read this questionnaire and comprehend it fully.

I understand that applying does not ensure approval
Where did you learn of Lone Rock Golden Retrievers?
Date*

MonthDayYear
Your name*
E-mail*
If we find you to be a good match for one of our puppies, a $500 deposit will be required to hold a puppy from the litter of your choosing. The final decision of which puppy is placed with your family will be up to Lone Rock Golden Retrievers. Input from potential families will be taken into consideration.

You will have the choice of having your deposit returned to you, or transferred to another litter of your choosing, should we not have a puppy available for you or we cannot meet your needs.

Thank you for choosing your puppy from Lone Rock Golden Retrievers!
Deposit type

PaypalVenmoCheck
Should be Empty: