YOUR INFORMATION
Full Name
*
First Name
Last Name
Phone Number
-
Area Code
Phone Number
E-mail
*
City
*
Province / State
*
Number of persons living in your home?
*
Number of Children (under 16) living in your home?
*
Do you live in. . . ?
*
apartment
condo
single family home
hobby farm
house with property (2+ acres)
farm
Other
Is your yard fenced?
*
Yes
No
we have no yard
WHAT ARE YOU LOOKING FOR:
Why are you considering a Chihuahua and not a Yorkshire Terrier or a Pug? (please be specific in regards to the traits found in the Chihuahau and not in other breeds)
*
What is it about our dogs that interests you? (why do you want a dog from our breeding and not another breeder?)
*
I am interested in:
A puppy
An older dog
Doesn't matter
Male or Female?
*
Male
Female
Doesn't Matter
When are you looking to get a puppy?
*
Please Select
I want a puppy ASAP
0 - 3 months
3 - 6 months
6 - 12 months
No Specific Time Frame
Coat Length
*
I would like a Short Coat
I would like a Long Coat
I don't care
What colour of dog do you want?
*
Black & White
Merle
Tri-colour
I don't care
How important is colour
*
1
2
3
4
5
Not important at all
VERY Important
1 is Not important at all, 5 is VERY Important
Have you previously owned a Chihuahua?
*
Yes
No
Did you raise the dog from a puppy?
*
Yes
No
What types of activities would you like to pursue with your CHI?
*
Pet/Companion Only
Competitive Agility
Conformation (Dog shows)
Competitive Obedience
Dog Park Socializing (designated off leash parks for dogs to interact together)
Therapy Work (Hospitals, Nursing homes)
Emotional Support Animal
Dock Diving
Flyball
Other
Do you currently own other pets? If Yes, please tell us about them.
*
Do you have any interest in breeding your CHI?
*
Yes
No
Don't know
Do you understand that we only sell our dogs on limited registration and you will not be able to breed your dog until it has passed required health testing?
*
Yes
No
How did you hear about Polka-Dot Chihuahuas?
*
friend
another breeder
internet search
Facebook
met a Polka-Dot dog
Other
Do you have any questions?
Submit
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