Adoption Application
For A PleasantDach's Puppy
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
What is your price range?
$1600 - $2000
$2000 - $2500
Are you a breeder or looking for breeding (Full AKC) rights?
Yes
No
Coat Type Preference
*
Long
Short
Coat Pattern Preference
Piebald
Dapple
Dapple - Pie
Solid Color - No Pattern
1st Color Preference
*
Cream
Red
Black
Blue
Chocolate
Isabella
No Preference
2nd Color Preference
Cream
Red
Black
Blue
Chocolate
Isabella
No Preference
1st Gender Preference
*
Male
Female
No Preference
Do you have your eye on a particular breeding pair, waiting list, or special puppy? If so please describe in detail.
*
Is this your first dog?
*
Yes
No
First time as an Adult
Is this your first time raising a puppy?
*
Yes
No
No, but it's been a while!
Do you have other pets at home?
*
No
1-2
2-3
4 or more
Do you already have a vet?
Yes
No
I need a recommendation
What type of housing do you have?
*
Single Family Home
Apartment
Condo
Other
Do you?
*
Own
Rent
Rent To Own
Other - Staying With Family
Do you have a fenced in yard?
*
Yes
No
Partially Fenced
Coming Soon
Is anyone in the household currently serving in the US military?
Yes
No
How many adults in your home?
*
1-2
2-3
3 Or More
How many children are in your home?
*
0
1
2
3 Or More
How many children are under the age of 5?
None
1
2
3 or more
All
How many minor children are in your home?
*
1
2
3 or more
All
None
Are all adults in the home in agreement to purchase a puppy?
*
Yes, we cant wait!
We are getting there ;)
No
Does anyone in the home have allergies to dogs?
*
Yes
None that we are aware of.
Where will the puppy be spending most of his/her time?
*
Do you believe in spanking a puppy for being naughty?
Yes
No
Only In Certain Cercumstances
Will the puppy be an inside or outside dog?
*
Mostly Indoors
Mostly Outdoors
Both
How many hours will the puppy be left alone?
*
Less Than 4
4 - 6
6 - 9
9 - 12
More Than 12
Is the puppy being purchased as a surprise or gift for anyone?
*
Yes
No
Are you aware of the dangers of Parvovirus?
Yes
No
Some, but would like more info.
Are you willing to keep the puppy indoors, and away from public places, until after the 5th Parvo shot or after 18 weeks of age? In order to protect your puppy?
Yes
No
Have you or anyone in the household ever been arrested, charged or convicted of animal cruelty or hording?
*
Yes
No
Will you be able to pick up your puppy in Atlanta, Georgia?
*
Yes, I live within 100 miles
Yes, I live within 250 miles
Yes, I live out of state but will make arrangements.
No, I need to make arrangements to meet or ship.
Do you agree to send follow up photo's & check in once in a while?
*
Yes
No
Do you agree to contact us in the case you no longer are able to keep the puppy & need to re-home?
*
Yes
No
Please provide any other relative information that you think would help assist us in placing a puppy in your home:
Do you have any other questions for us?
How did you hear about us?
*
Family
Friend
Website
Facebook
Other
Your Signature
Send my application!
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