Application Form

Application Form

Please fill out the application completely. You can save this form at any time by scrolling to the bottom and clicking the "Save" button. If you have any questions, you can call or text me at 352-672-5045.
Date

MonthDayYear
Date
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How did you hear about me?
If it was a referral, and you don't mind, would you share their first and last name so I can thank them.
Do you have a website? If so, please share the address.
Are you looking for a Poodle or a Havanese?
Is there a particular puppy/dog on my website you are interested in? What is the name of the puppy/dog?
What sex of puppy or dog do you prefer?
What is the time frame you are looking to bring a puppy or dog home?
Are you willing to come get your puppy at our home?

Other
Do you agree that you will NEVER take the puppy/dog to a shelter? (I will always take my puppies/dogs back regardless of the circumstances.)

Other
Do you have a fenced in yard?

Other
Do you agree that should something happen and you can no longer care for your puppy that you will notify me and either have a safe and responsible home lined up for it or agree to return it to me? As the breeder, I will always care where my dogs are and will always take it back regardless of the circumstances. (check all that applies)

Other
Do you understand this puppy will require frequent coat care/grooming?

Other
How I will keep up with veterinarian care, vaccinations, medical treatment.

Other
How many hours a day will your puppy/dog be left alone?

Other
Where will your puppy stay when left alone?

Other
Where do you plan to have your puppy/dog go potty? (can choose more than one option)

Other
What type of home do you reside in?

Other
If you live in an HOA or have a landlord, are you allowed pets/dogs? Click "Other" if none of the options below apply to explain.

Other
Have you asked me for a copy of my contract and if so, have you read it?
Is anyone in your home allergic to dogs?

Other
If you have ever owned a pet with separation anxiety, please explain how you handled it.
If you have ever owned a pet that was aggressive or possessive, how did you handle it?
Do you accept and understand that we require a non-refundable deposit to secure a puppy as yours until it goes home with you? (This means if you change your mind you do not get your deposit back) Your deposit will only be returned *if* the puppy fails a health test at the time of sale.

Other
Please describe your ideal pet. Size, color, personality, anything specific that you're looking for. This helps me to determine which pup may be best for you.
Please list your current pets (breeds/sizes ages) you currently have. Include small animals as well.
Who lives in the house with you? Please list all people/children and their ages.
If you've had dogs before, what did you have and why do you no longer have them?
Are you agreeable to spay/neuter your dog when it's age appropriate if the dog is going to you on a limited registration?

Other
Do you plan to show/compete with the puppy/dog?

Other
What experience do you have with canines? Are you willing to be mentored if you are a first time owner?
Do you have a plan if you are unable to take care of you fur baby for the next 10-20 years? (check as many boxes that may apply)

Other
Are you prepared for grooming costs for the life of your new companion? They have hair so you should use shampoo, conditioner, blow dryer, brush and comb once a week....like humans do.

Other
Are you prepared for costs of Feeding Good food? It saves vet bills to have a healthier pet with good quality diet.

Other
What type of food do you feed? (You can choose more than one option)

Other
What brand of food(s) are you currently using
Please supply your veterinarian's name and phone number as well as the clinic's name and address
Please supply a reference (name and phone number)
Please supply a second reference (name and phone number)
Have you ever bred a dog and had a litter(s) in the past? (check all that may apply)

Other
If you plan to breed, do you plan to or do health testing on your breeding dogs?

Other
Please describe your ideal puppy and what traits you are looking for to add to your breeding program.
Please describe any experience you might have with showing, health testing, breeding, animal husbandry, whelping, etc.
Please list the breeds of dogs you have raised in the past and currently, if any.
If you reside in Florida and are a breeder, are you aware of the pet lemon law for breeding dogs?
Is there anything you wish to tell me so I can match you with a puppy?
I understand that by filling out this application putting my name in the "signature" field I acknowledge that the application does not entitle me to a puppy/dog or guarantee that I will get a puppy or dog from the breeder. I understand the application gives the breeder a good idea of who I am and how I'd care for one of their puppies/dogs. I also understand that many people view the website and the available puppies and that a puppy I may be interested in may already be spoken for by someone else. I fully realize that the breeder has the puppy's/dog's best interest at heart and is only doing what is best for each of the available puppies or available dogs to ensure they go to a wonderful, safe, responsible and loving home.

Other
By typing your name you acknowledge I am 21 or over and I agree to the terms of the breeder. I also acknowledge that the answers I gave you are true.
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