Burpee's Mill Cockers
Owner Application
Personal Information
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address of Where Your New English Cocker Will Reside
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Have you ever owned a dog or been raised with dogs?
*
Yes
No
What breed(s) and how many years?
*
How much outside room will your English Cocker have to roam, explore, be trained on, and call home?
*
Have you ever owned a dog or been raised with dogs?
*
Yes
No
Provide details
Do you presently have pets in your home?
*
Yes
No
Dog(s)
Cat(s)
If yes, how many of each?
What breed(s) and how many years?
*
Please describe in a typical day, the amount of time (hours) you will and will not be at home due to work, commitments, or activities and what you would do with your pup during that time.
*
In order to match you to the right puppy, please describe your lifestyle such as activates, travel, exercise, hobbies, etc.
*
Family & Home Information
How many adults are living in the home?
*
Do you have children at home?
*
Yes
No
Provide detailed information about your children's ages and some more specific information.
Does any family member have allergies to animals?
*
Yes
No
Is everyone in the household in agreement to adding a new pet to the family at this time?
*
Yes
No
What is your occupation/source of income?
What is your home type?
*
Detached
Semi-detached
Townhouse
Do you have direct access to a securely fenced yard from your home?
*
Yes
No
Care of Your English Cocker & Your Intentions
How do you plan on utilizing your dog? For example: will he/she be a companionship pet, hunting/sport purposes, therapy/service animal?
*
Should your intention be anything aside from a family pet, or companion, do you have plans in place for training? If so, please provide the trainers information.
How much are you willing to spend for emergency veterinary care for your puppy?
*
Do you intend to take out pet insurance for your puppy?
*
Yes
No
Undecided
How long will your puppy be left alone during a typical day? (Please be specific about hours of work/commute times, schedule, etc)
*
Where will you keep your puppy at night?
Where will your puppy stay while you vacation?
Additional Information
How did you hear about us?
Any additional comments
Please pick a desired date and time for us to be able to visit your property either in-person, or virtually, so that we can have an idea of where your English Cocker will call their furever home.
*
Submit
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