• What is your name & what city & state do you live in? What is your email address?

  Name
  City
  State
  E-mail

• Type of Dwelling you live in: (Choose one)

house
duplex
apartment
mobile home

• Do you own or rent your home? (Choose one)
  Own     Rent

• Is your yard fully and securely fenced? 
  What type of fencing is your fence composed of?

• What size is your lot? (Choose one)

  Small    Medium    Large    Extra large    Acreage

• Where will the dog be kept? (Choose one)

  Mainly indoors    In at night & out all day    Only outdoors
  

• Will the dog be tied up? 
  Yes      No

• Where will the dog be kept when home alone or when you are unable to supervise?

• How many hours of the day will the puppy be left alone?

• Have you had dogs before or currently? Please list any currently owned pets (all types) including type & age.

• Is any member of your family allergic to dogs? 
  Yes      No

• What is your planned method of exercise? What is the amount of exercise you are expecting and willing to provide daily?

• Do you have children? If so what are their ages?

• Why do you want this dog?

• What sex, size and color do you prefer?

• What type of temperament are you looking for?

• Would you be willing to accept a home inspection by myself or a friend, prior to approval for a puppy purchaser?
  Yes      No

• Any other information you wish to add to assist in matching you with a puppy?