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Date
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Day
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Date
Name
*
First Name
Last Name
Address
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Street Address
Street Address Line 2
City
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Postal / Zip Code
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Color preference?
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Black
Red
Either
Puppy sex preference?
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Please Select
Male
Female
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Do you want your puppy cropped?
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Yes
No
If yes to cropped, have you ever posted ears?
Yes
No
Have you ever owned a Doberman?
*
Yes
No
If yes to owning a Doberman, when?
Do you have children?
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Yes
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If yes to children, their ages?
What additional information can you add about yourself, your family, and your pets?
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References
List a Veterinary and two personal references.
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Relationship
*
Please Select
Veterinary
Personal
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Relationship
*
Please Select
Veterinary
Personal
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Relationship
*
Please Select
Veterinary
Personal
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Puppy Environment
Do you have a fenced yard? (describe) If not please explain exercise plan?
*
Where will the puppy be housed at day/night?
Do you own your home?
*
Yes
No
If yes, does your insurance allow Dobermans?
*
Yes
No
N/A
If no, do you have permission to have a Doberman?
*
Yes
No
Describe Permission? (write NA if own your own home)
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Why a Masaya Doberman?
Why do you want to own a Masaya Doberman?
*
What types of activities do you anticipate enjoying with you Doberman? (walking, jogging, schutzhund, obedience etc...) ?
*
What Doberman qualities are most important to you?
*
If you are interested in purchasing a performance dobe, what club/trainer will you be training with?
*
Have you ever titled a dog? (describe) :
*
Signature
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