Puppy Application
Church Creek Retrievers
Personal Information
Name
Last Name
First Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Format: (000) 000-0000.
Text Okay
Call Okay
Household Information
Name everyone who lives in the home along with their ages
What type of housing do you live in?
Suburban house (less than an acre)
Rural house (more than an acre)
Apartment / Condo
Other
Do you have a yard?
Yes
No
Is your yard fenced?
Yes
No
N/A
Do you rent or own?
Rent
Own
Describe any other pets you currently have (type of animal, breed of dog, ages, etc...)
Is there anything else you would like me to know about your housing situation?
Primary Caretaker Information
Who will be the primary caretaker of the puppy?
Does the primary caretaker work? If so explain schedule
How many dogs have you owned in your lifetime? Which breeds?
Have you ever raised a dog from puppyhood?
Yes
No
Have you ever owned a field-bred golden retriever?
Yes
No
Explain how you plan to care for the needs of your puppy. Include whether someone will always be home during the day. If not, how many hours at a time will the puppy be left? How will the puppy be kept safe while left alone? etc...
How many hours at a time will the puppy be left alone?
Puppy Plans
Why do you want a field-bred golden retriever?
What traits are you looking for in a dog? What traits are you NOT looking for?
Where will your dog sleep? Be specific. (i.e., crate in the garage, on the porch outside, couch in the living room, etc...)
Will your dog ever be allowed off-leash?
Yes
No
What plans do you have for your puppy? Check all that apply:
Companion / Family dog
Training
Recreational activities (i.e., hiking, swimming, etc...)
Therapy work
Hunting
Sporting / Title work
Breeding
How do you plan to provide for your dog's exercise needs?
Our contract requires that you train your dog. How do you plan to do this?
Describe your experience training dogs:
Do you have a preference on gender?
Male
Female
No Preference
If your preference is unavailable what course of action would you prefer:
I would take the available gender
I would like to remain on the waitlist for my preferred gender
I would like my deposit refunded
N/A (I do not have a preference)
Are you okay with the breeder selecting your puppy after performing temperament testing and determining a good match to your lifestyle?
Yes
No
Other
How did you find Church Creek Retrievers?
Referral
Google Search
Gooddog
AKC Marketplace
Other
I would like my next step to be:
Reserve a place on the Reservation List (Phone interview, sign agreement, and pay $500 deposit)
Be added to the email list to be notified about breeding plans - you will be notified when our next heat comes, but this does not confirm a place in the litter. (no further steps necessary)
Ask more questions (email correspondence)
Affirmations
Are you prepared to take responsibility for this dog for the entirety of its life? (Our contract prohibits rehoming. If you are unable to care for your dog you will surrender to the breeder with no refund.)
Are you prepared to financially care for this dog including quality food, proper toys and treats, veterinary care, and flea/tick/heartworm prevention medications?
Do you understand puppies must be picked up at 8 weeks of age, and affirm you are able to do that?
Signature
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
Submit
Should be Empty: