Puppy Raising Application

Puppy Raiser Application

Please fill out this form accurately.
Name*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
example@example.com
Mobile Number*

Area CodePhone Number
How many years of experience do you have with dogs? *
Housing status *
What makes you a good fit for our program?*
Do you have a fenced yard?*

YesNo
Will you be the primary care provider for this puppy?*

YesNo
Job status*

Full time/40hrsPart-time/up to 32hrsJoblessSelf employed
Are you willing to keep up with routine appointments for the puppy? *
Please list all people living in the household including ages and relation*
Are you willing to take this puppy on car rides and to socialize at least 4 days per week?*
Does anyone in your household have allergies to dogs or pet dander?*
Please list any pets that currently live with you, including breed and age*
If you have a dog or multiple, how do they react when someone rings the doorbell, knocks on the door or when they experience something unpredictable? If you do not have a dog please type N/A*
If you have a dog, is it fearful or aggressive towards anything? *
How long will the puppy be left alone per day? *
What is your experience with dogs and dog training
Vet reference *

First name Last name
Vet reference *

Vets number and locationAccount name
Reference we can contact
Are you able to travel? And if so how far? And how often?
Instagram handle
Should be Empty:

Puppy Raiser Application