Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Format: (000) 000-0000.
Email
*
example@example.com
Please provide number of people and ages in your household (including yourself):
*
Do you work in or outside of your home?
*
How do you see a corgi fitting in your lifestyle?
*
How many pets and what kind do you currently have?
*
Have you owned and trained a dog before?
*
Do you currently have a vet you use?
*
Do you have a fenced in yard? If not, how do you plan to exercise/potty your dog?
*
Do you have a pool and is it completely fenced in?
*
Will the dog be left alone for more than 4 to 6 hours during the day?
*
Do you travel? If so please tell us how the dog will be cared for in your absence:
*
What activities would you like to pursue with your dog?
*
Family Companion
Performance: Agility, Obedience, Herding
Therapy Work (take to hospitals and nursing homes)
If you are interested in activities other than a companion, what are your goals?
What Sex do you prefer?
*
Male
Female
No Preference
What is your time frame for getting a dog?
Immediately
In the next 6 months
In the next year
Doesn't matter - I am willing to wait for the right dog
Are you open to an older puppy (6-12 months) or a retired adult?
Please Select
Yes
No
Do you plan on taking your dog to training classes?
Please Select
Yes
No
Describe the ideal character of your future Corgi:
*
How did you hear about us?
*
What is the best day and time to discuss your application over the phone?
*
Please include any questions or information you feel is important for us to know:
Submit
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