Puppy Application Form

Your Name : *

E-mail : *

Phone Number : *

Address : *

Gender of puppy wanted : *

Other comments / inquiries :

Are you interested in a specific puppy or litter? *

How did you hear about our kennel? *

Why have you decided that the Yorkshire Terrier is the breed you wish to own? *

Have you ever owned a Yorkshire Terrier before? *

What other breeds have you owned? *

Do you have any other dogs or pets? *

Who is your current veterinarian? Phone number? *

Are ALL members of the family ready for a new dog? *

Do any family members have allergies to dogs? *

Ages of children in the home? *

Who will be the primary caretaker for the new puppy? *

Do you and/ or your spouse work full-time? *

How many hours per day will your puppy be alone? *

Do you and your family have an active/outdoorsy or an relaxed/leisurely lifstyle? *

Would you describe your family’s household as active/busy or quiet/relaxed ? *

Have you ever had to rehome a pet and why? *

Have you ever had to euthanize a puppy or dog other than for old age? *

If you are renting, does your current lease allow you to have pets? *

Yes No

Do you have any intentions of breeding this dog? *

Yes No

Are you able and willing to keep up with routine medical care? *

Yes No

Are you able to afford veterinary bills if an emergency arises? *

Yes No

Will you continue to feed your new puppy a quality diet? *

Yes No

Do you understand that a puppy is a lifetime commitment? *

Yes No