Pug Contact Form
Email
*
example@example.com
Phone Number
-
Area Code
Phone Number
I am/We are the applicants. I/We are not planning to give or sell this dog to anyone else. This application is on my/our own behalf.
*
Agreed
Have you read through both our Health Issues, PDE and Nursery pages?
*
Yes, I have
No, I have not
Do you currently or have you ever owned a Pug?
Yes
No
Does anyone in the home have any known allergies to pets? Pugs shed alot!
*
Yes, please explain below
No
Unknown
Other
Has anyone in the home been in contact with Parvo?
*
Yes, if so how long ago? Please explain in extra information.
No
Unknown
Are there any other pets in the home? If so are the spayed or neutered? If not please explain below
*
Do you intend to keep your new Pug current on recommended vaccinations?
*
Yes
No, please explain below
How long will your pug be left alone during the day? Where will your pug spend it's time while you are away?
*
When are you hoping to acquire your new Pug? ex: 6 months, next year etc..
*
What is your color and sex preference? Please note that we do not breed Black Pugs
*
Fawn Female
Fawn Male
No preference or undecided on male or female
Are there any children in the home? If so what are the ages?
*
Has anyone in the home surrendered a Pet to the SPCA, animal shelter or rescue? If so please explain
Yes (please explain below)
No
Who will be the primary caregiver of the Pug?
*
Do you have a fenced in yard?
*
Is everyone in the home in an agreement to purchasing the Pug breed?
*
Yes
No
Are you willing to contact me if you have any questions about the pug's behaviour, or any health concerns?
*
Yes
No, please explain below
Do you rent or own your home? If you rent have you discussed and received permission from your landlord to have a Pug?
*
Where are you located and how far are you willing to travel?
Any other information you would like to include
Enter the message as it's shown
*
Submit
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