Name *

First Name

Last Name

Are you inquiring in a specific puppy currently available, or a breeding on the way? (If yes, provide name of puppy, or sire/dam of breeding)

yes

no

Would you like your new puppy(s) ears cropped? (deposit required)

Yes

No

Do you have a color preference? (List up to three, in order of preference)

1.

2.

3.

Protection & Guard

(Please select all that apply) r

Pet Family

Protection & amp

Guard

Dog Conformation &amp

Showing

Sport

Personal Protection

Schutzhund

Obedience

Agility

Weight

Pulling

Breeding

Other

Are you at least 18 years of age and able to enter into a legal agreement ?

Yes

No

Will your dog live primarily live within your home ?

INSIDE

OUTSIDE

How long have you lived at this residence?

Yes

No

Do you have any plans to move soon ?

Yes

No

Have you ever surrendered a dog (to a pound / humane society / rescue group / etc.) for any reason? (If yes, what was the reason?)

Yes

No

Have you owned a dog before?

Yes

No