Name *

First Name

Last Name

Phone *

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Residence *

Home

Apartment

Condo

Other

Special Considerations *

Is there anyone in your household who is

Elderly

Disabled

Has special needs

Is allergic to dogs

None of the above

How many dogs have you previously owned? *

0

1-2

3-4

5+

Have you ever raised a puppy? *

Yes

No

Have you ever surrendered a puppy to a breeder or rescue or brought one back to another breeder? *

Yes

No

Sex *

I prefer

Male

Female

Either

Energy Level *

The energy level in my home could be described as

We are a very low-energy household and need a dog that shouldn't be expected to do or get out much beyond potty breaks and the occasional short walk.

We are sporadically active and want a dog that is more interested in lounging than playing.

We lead a moderately active life and are frequently busy and want a dog that we can do things with on weekends.

We are a very active household and always on the go and want a dog that is energetic enough for daily physical activity (this includes families with kids that will play daily with the dog).

We are energizer bunnies and need a very active dog that can keep up with multiple daily activities.

Other, I will describe below

Puppy Plans *

My puppy is intended to be (select all that apply):

A pet and a companion

A Service Dog or Assistance Dog candidate (provides specific tasks for one individual)

Emotional Support/PTSD/Anxiety Dog candidate (I have a referral from or am under the care of a health professional for this)

A Therapy Dog candidate (provides comfort in facilities such as hospitals and nursing homes for a variety of individuals)

A breeding dog

SPAY AND NEUTER REQUIRMENT *

• I understand that this puppy is not to be bred and is required to be spayed/neutered (unless stated in the puppy agreement I sign), and I am subject to significant fines and other damages as stated in the contract if not spayed/neutered and/or bred. • I understand that the contract requires spay/neuter between 4-12 months of age, no exceptions. • I understand these requirements are in the purchase contract for the puppy and will not be changed after you sign your contract. For this reason, we recommend you discuss this with your vet PRIOR to making your reservation.

Yes, I agree to the spay/neuter and no-breeding condition of this contract.

No, I do not agree to the spay/neuter and no-breeding condition of this contract.

I am a breeder and am purchasing breeding rights

Reservation Application Terms *

Please check the following boxes to signify that you agree to these terms

I understand that my Reservation Fee gives me a place on the reservation list in order of acceptance.

I also understand that the breeder, however, has the right to select breeder choice puppy or puppies from any litter and therefore maintains top two pick spots.

I have chosen this breeder because of her expertise and experience. Therefore, in the best interest of the puppies and of my family, I agree that the breeder also reserves the right to not offer a given puppy to a family if she believes that the puppy would not be suitable for that family for whatever reason.

Reservation Fee- $300 *

I will submitted my reservation fee via

Zelle

Wave

Certified Check

Cash App

Google Pay