Adoption Application

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?

Are you a breeder or looking for breeding (Full AKC) rights?

Coat Type Preference *

Coat Pattern Preference

1st Color Preference *

2nd Color Preference

1st Gender 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? *

Is this your first time raising a puppy? *

Do you have other pets at home? *

Do you already have a vet?

What type of housing do you have? *

Do you? *

Do you have a fenced in yard? *

Is anyone in the household currently serving in the US military?

How many adults in your home? *

How many children are in your home? *

How many children are under the age of 5?

How many minor children are in your home? *

Are all adults in the home in agreement to purchase a puppy? *

Does anyone in the home have allergies to dogs? *

Where will the puppy be spending most of his/her time? *

Do you believe in spanking a puppy for being naughty?

Will the puppy be an inside or outside dog? *

How many hours will the puppy be left alone? *

Is the puppy being purchased as a surprise or gift for anyone? *

Are you aware of the dangers of Parvovirus?

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?

Have you or anyone in the household ever been arrested, charged or convicted of animal cruelty or hording? *

Will you be able to pick up your puppy in Atlanta, Georgia? *

Do you agree to send follow up photo's & check in once in a while? *

Do you agree to contact us in the case you no longer are able to keep the puppy & need to re-home? *

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? *

Your Signature

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