Application

Application Form

* Indicates required field

Name *

First

Last

Email *

Phone *

Cell Phone *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Name of Employer *

Preferred colors and coat types *

Preferred Gender *

Male Female No Preference

Will you pick up this puppy or require shipping? *

I understand additional charges will apply for puppies NOT picked up in a timely manner. Yes/No *

Allergy Concerns? Yes/No Mild/Severe? *

# of children in your home? *

Have you owned a dog before? Yes/No *

How many dogs do you currently own? *

Puppies require a tremendous investment of both time and money. Are you prepared and committed? Yes/No *

Will this puppy be taken for required immunizations and veterinary care? Yes/No *

Will this dog be spayed or neutered within the first 9 months and confirmation sent to us? If purchasing a puppy for breeding purposes, additional costs and evaluations will apply. *

Yes No, I wish to have this dog bred.

How did you find out about us? *

How do you wish to make your $200 deposit? *

Paypal (we will contact you to set up) I will mail a check or money order payable to Dave Ganoe.

Submit