Form
Interlock Puppy Application
Email
*
example@example.com
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation/Hours
Spouse Name
First Name
Last Name
Spouse Occupation/Hours
Housing
House I own
House I rent
Apartment
Townhouse
Fenced in yard
Yes
No
Willing to put one up
Fence height/materials
Are you familiar with the exercise, grooming and nutritional needs of a sporting breed dog?
Veterinarian Contact
Where will your puppy be kept during the day?
Where will your puppy sleep at night?
Are you willing to participate in obedience classes with a puppy?
Yes
No
Who is your dog trainer? (Past/current/future)
Have you ever rehomed a pet? If so, why?
Activities you are interested in pursuing with a puppy
Hiking
Hunting
Hunt tests
Canine Good Citizen
Rally/Obedience
Agility
Scentwork
Canicross/Bikejoring
Conformation Shows
Breeding
Therapy
Gender Preference
Male
Female
No preference
Are you willing to wait for a future litter if a puppy is not available?
Yes
No
How did you hear about our breeding program?
Submit
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