Puppy Application
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.
Email
*
example@example.com
My marital status is:
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Single
Married
Other
Spouse's name
Please list your occupation, your spouse’s/partner’s occupation and the number of hours each of you work per day:
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Do either you or your spouse travel for work? If yes, who, how often and for how long?
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Who will be the primary caretaker?
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Our lifestyle is:
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Relaxed
Active
Other
If other. Please explain.
Do you rent or own?
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Own a house
Rent a house
Rent an apartment
If you rent. Please provide landlords name and phone number
Do you have any children. Please list their name, gender and age and if they have any special needs.
*
Do you currently have any pets? If so please list,species, breeds, ages, fixed or not fixed.
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Have you had a Chesapeake Bay Retriever before? If no, why are you interested in the breed?
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Preferred Sex?
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Male
Female
Are you willing to take the opposite sex if it's a better fit for your family?
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Yes
No
If no please explain why.
Color
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Brown, dead grass, sedge
My main reason/s for acquiring a Chesapeake is.
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Hunting
Hunt Tests
Pet/companion
Therapy
Service Dog
Search & Rescue
Tracking
Performance Sports (fast cat, dock jumping)
Other
Personality preferences? ie quiet, rambunctious, birdy)
*
Do you intend to spay or neuter your puppy?
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Yes
No
If Yes, at what age? If NO please explain. (We highly encourage you to NOT spay or neuter until 2yrs of age.)
All puppies are sold on limited registration. (Limited Registration means that the dog is registered but can not be shown conformation and any litters produced by the dog will result in a $5,000 (five thousand dollars) fine and litter is unable to be registered.) Do you understand this?
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Yes
I would like to discuss full registration.
If you are interested in full registration for showing or breeding, please explain why.
What experience do you have raising/training a puppy?
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Do you plan to crate train?
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Yes
No
Do you have a fenced in yard?
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Yes
No
If no, how do you plan to keep your new puppy in the yard?
Where will the dog spend most of his/her time?
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In your home/outside in a dog run ect.
What will the typical day in the life of this puppy/dog be like?
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How much time will you have to exercise and interact with your new puppy?
What are your expectations for your new puppy within their first year:
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Within his/her lifetime:
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Anything else you would like to tell me about yourself.
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Please list 2 personal and 1 vet reference with phone, email and relationship for us to contact. Personal 1
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Personal 2
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Vet
*
File upload
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Please upload a photo of yourself and/or your family if you would like.
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Please understand I do NOT do a wait list as first come first served. I choose who will get a puppy based on which home fits each puppy best. Hunting and Performance homes are preferred unless I have a very quiet puppy that fits best in a companion home.
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Understood
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