Puppy Application Form

Puppy Application

The information contained in this application is used only for the purpose of placing a puppy and will not be used elsewhere. A $500 deposit to hold your puppy will be collected after your application is approved, and will be deducted off the total price of the puppy.
Deposit type
Full Name

First NameLast Name
Profession
E-mail
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number - Home

Area CodePhone Number
Phone Number - Cellular

Area CodePhone Number
Lifestyle:
With these questions, we will be able to match the puppy better with its new home.
Do you live in a:
Household Setting
Do you have children at home?
Does Anyone in your household have allergies to animals?
If yes, please indicate type, severity and if medication is required to manage.
Have you owned a dog before?
Do you have any pets now?
What Gender are you looking for?
Do you have a veterinarian you plan to use?
Do you have a fenced yard?
For the safety of your puppy, when not in an enclosed fence area, please keep your puppy on a leash at all times.
Will the puppy live indoors?
Do you work outside of the home?
How many hours in a day would the puppy be left alone?
On average a puppy shouldn’t be alone more than 5 to 6 hrs. a day
Do you understand the time and energy it takes to care for a puppy:
Please list your working dog expierence.
Do you have a job in mind for your puppy?

Other
Do you agree to contact van Horushuis Dutch Shepherds in the event you cannot keep your puppy?
Please indicate anything else that may help us with selecting the right puppy for you.
By sending this electronically, I acknowledge that I have completely read this questionnaire and comprehend it fully.

I understand that applying does not ensure a spot on the waitlist
Date

MonthDayYear
Your name
E-mail
Should be Empty: