Southpaw Pomskies Puppy Application

SOUTHPAW POMSKIES 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
Date of Birth*

MonthDayYear
Date
E-mail*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
How would you like us to contact you regarding your application?*

Phone CallText MessageEmailOther
LIFESTYLE
With these questions, we will be able to match the puppy better with its new home.
Occupation*
What is your living situation?*

I own a houseI rent a houseI rent an apartmentOther
Do you have a fenced yard?*

YesNoPartial
Household Setting*

RuralSuburbanUrban
If renting, are you able to provide proof a dog may be added to the home?*

YesNoN/A ( I own my home)
Do you work outside of the home?*

YesNo
How many adults reside in the home?*
Do you have children at home?*

YesNo
If yes, please list the age of each child
Does anyone in your household have allergies to animals?*

YesNo
If yes, please indicate type, severity, and if medication is required to manage.
The energy level in my household is:*

Low-energy household and need a dog that shouldn't be expected to do or get out much beyond potty breaks and the occasional short walk.Sporadically active and want a dog that is more interested in lounging than playing.Moderately active life and are frequently busy and want a dog that we can do things with on weekendsVery active household and always on the go and want a dog that is energetic enough for daily physical activity (this includes families with kids that will play daily with the dog)
CURRENT AND PAST PET EXPERIENCE
Have you owned a dog before?*

YesNo
If yes, please indicate how many dogs you have owned as an adult (first-time owners are welcome to apply!)
Do you have any dogs now?*

YesNo
If yes, please list the breed(s) and gender(s)
If yes, please indicate if your dog(s) is spayed, neutered, or unaltered/intact
Do you have any other pets now?*

YesNo
If yes, please list the species of each
PUPPY PLANS
Have you researched the breed?*

Yes, I have done extensive researchI have done some researchNo, please send me some info
What gender are you looking for?*

MaleFemaleNo Preference
What size are you looking for?*

Toy (up to 10" tall at shoulder, 15lb)Mini (up to 14" tall, 12-20lb)Standard (up to 18" tall, 20-35lbLarge ( greater than 18" and 35lbNo preference
Do you have a veterinarian you plan to use?*

YesNo
Will the puppy live indoors?*

YesNo
Where will the puppy sleep? (Please be specific, e.g., in a kennel in the garage, in a playpen in the kitchen, in a crate in my bedroom, on the bed with my kids) *
How many hours in a day would the puppy be left alone or kenneled?*
Have you ever raised a puppy (not including puppies your parents raised during your childhood)*

YesNo
Have you ever rehomed, surrendered to a shelter, or returned a dog to a breeder?*

YesNo
If yes, please explain
Do you understand the time and energy it takes to care for a puppy:*

YesNo
Socialization with humans and other dogs is critical to the healthy emotional development of a puppy. How do you plan to properly socialize your puppy given these circumstances?*
Puppies often have a lot of energy and can chew, dig, bark, soil the house, and cry at night. They can play roughly and scratch your skin with teeth and nails, they can get sick on floors, furniture, and in cars. Please tell us your patience level and how you might deal with the challenges of puppyhood.*
How will you train your puppy?*
My puppy is intended to be (select all that apply):*

A pet and a companionA Service Dog or Assistance Dog candidate (provides specific tasks for one individual)Emotional Support/PTSD/Anxiety Dog candidate (I have a referral from or am under the care of a health professional for this)A Therapy Dog candidate (provides comfort in facilities such as hospitals and nursing homes for a variety of individuals)A breeding dog
If you checked anything other than "A pet and companion" in the question above, please elaborate on your needs.
Will the puppy be picked up?*

YesNo
Will you need the puppy to be delivered (additional cost)?*

YesNo
Puppies can be delivered anywhere in Canada and the USA at an additional cost
When are you looking to add a puppy to your family? Ex: within the next 12 months, within the next few years. Note that we do NOT have any availability for 6-12 months. Please abandon this application if you are not prepared to wait 6-12 months for your puppy.*
Do you agree to contact us in the event you cannot keep your puppy?*

YesNo
Would you like to pay a retainer fee to be added to our waitlist?*

YesNoI would like to speak to you first
Is there a specific, available puppy that you are interested in?

NoOther
Please indicate anything else that may help us with selecting the right puppy for you.
How did you hear about us?*
By sending this electronically, I acknowledge that I have completely read this questionnaire and comprehend it fully.

I understand that applying does not guarantee approval
Date*

MonthDayYear
Name*
E-mail*
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SOUTHPAW POMSKIES PUPPY APPLICATION