POSH Puppy Application

Full Name

First NameLast Name
E-mail
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Is this application for a currently available litter?

YESNO
Primary care giver's age:
Primary care giver's occupation:
List the gender and age of individuals who reside in the home:
List the number, age, gender, species of other pets in the home:
Number of daytime hours the puppy will be alone:
Number of evening hours the puppy will be alone:
Describe where this puppy will be maintained during the daytime hours:
Describe where this puppy will be maintained during the evening hours:
List the veterinarian, address and phone number who will provide care for this puppy:
If left indoors without supervision, where will the puppy be kept:

In a crateConfined to a roomLoose in the houseOther - specify below
If left outdoors without supervision, how will the puppy be maintained?

tied out on a chainfenced yardpen / kennelrun looseNo unsupervised outdoor timeOther - specify below
If you go out of town, who will care for the puppy?
What would you do with the puppy if you found you could no longer care for it?
Please explain your interest in getting a puppy at this time:
Please explain your interest in a POSH puppy, specifically:
Do you understand that we do not place puppies with breeding rights?

YesNo
What gender puppy are you seeking?

MaleFemaleDoes not matter - best puppy for me
If you are exclusively interested in a specific puppy listed on our website, please identify it here:
Please offer any additional information you would like to share:
Should be Empty: