Puppy Application Form

Name

Please enter your first name

Please enter your last name

Email

Please enter a valid email address

Phone

- -

Address

Why did you decide on a Golden Retriever?

Do you have a fully fenced and secure yard?

Yes

No

Is anyone in your family allergic to dogs?

Yes

No

Don't know

Is anyone in your family afraid of dogs?

Yes

No

Do you have children? If yes, what are their ages?

Will this puppy be a full time house dog?

Yes

No

Who will train the puppy?

Do you plan on attending puppy and obedience classes?

If not, why not?

Do you work full time?

Yes

No

Do you work from home, or outside of the home?

From home

Outside of home

If you work outside of the home, how long will pup be left alone?

Have you made arrangements during the day if your pup will be left alone for extended periods of time?

Have you owned a dog before?

Yes

No

If yes, what breed(s) and how long ago did you have him/her?

If you currently own a dog, what age/sex/breed?

Do you have any other pets (cats, rabbits, birds etc.)?

Do you prefer a male or female puppy?

Male

Female

Either

Do you agree to spay/neuter your pup, as per breeder recommendations?

Yes

No

Are you aware of the costs associated with owning a dog?

Yes

No

Is there any other information that you would like to add?

Where did you hear about us?

Puppy Application Form

Personal Information

About You and Your Home

Previous Pet Experience

Puppy Preferences

Application Submitted Successfully!