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
Sex
*
Male
Female
Are you willing to take the opposite sex if it's a better fit for your family?
*
Yes
No
If no please explain why.
Color
My # 1 reason for acquiring a Chesapeake is.
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Hunting
Pet/companion
Conformation show
Performance show
Hunt tests
Therapy
Other
My preferences are (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.
All puppies are sold on limited registration. (Limited Registration means that the dog is registered but no litters produced by that dog are eligible for registration) Do you understand this?
*
Yes
If you are interested in full registration, please explain why.
Please list the expectations you have of your Chesapeake puppy:Within the first 6 months:
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Within the first year:
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Within his/her lifetime:
*
Where will the dog spend most of his/her time?
*
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?
Do you plan to crate train?
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Yes
No
What will the typical day in the life of this puppy/dog be like?
*
Please tell me more about yourself.
*
Do you live in a house or apartment? Rent or own?
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House
Apartment
Own
Rent
If you rent. Please provide landlords name and phone number
*
Do you currently have any pets? If so please list,species, breeds, ages, fixed or not fixed.
*
If you do not currently have any pets, what experience do you have raising/training a puppy?
*
Who will be the primary caretaker?
*
My marital status is:
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Single
Married
Other
Do you have any children. Please list their name, gender and age and if they have any special needs.
*
Our lifestyle is:
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Relaxed
Active
Somewhere in between
I/ We participate in the following activities: Alone:
*
With my/our family:
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With my Chessie:
*
Please list your occupation, your spouse’s/partner’s occupation and the number of hours each of you work per day:
*
Do either you or your spouse travel for work? If yes, who, how often and for how long?
*
Please list 2 personal and 1 vet reference with addresses, phone, email and relationship for us to contact. Personal 1
*
Personal 2
*
Vet
*
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