Application Form

Name *

Email *

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Telephone Number

Questions for you

Have you researched this breed?

Have you every owned a PWD before?

Yes
No

If NO, why do you want a PWD now?

If YES, do you still have the dog?

If YES what is the gender

Male
Female

If YES has if been spayed or neutered

Yes
No

If YES what is its age

Do you have any experience with large dogs?

Yes
No

Have you owned dogs before?

Yes
No

If YES what happened to them?

Do you have any other pets?

Yes
No

If YES please describe

Do you groom your pets yourself or do you have them professionally groomed?

I groom them myself
I have them professionally groomed

Do you live in a house or apartment?

House
Apartment

Do you rent or own?

Rent
Own

If you rent does your rental agreement allow you to keep dogs?

Yes
No

Do you have a yard?

Yes
No

If YES is it fenced?

Yes
No

If NO how do you plan to exercise your PWD?

How many people in your household?

Do you have children in your household?

Yes
No

If YES how many and what are their names and ages.

Is everyone in your household agreeable to adopting a PWD?

Yes
No

Does any member of your household have allergies?

Yes
No

If YES please describe

Who will be the main caregiver?

What are you interested in participating in? (please check all that interests you)

Are you prepared to assume the financial responsibilities of caring for an animal, including inoculations, veterinarian care, good quality food, licensing, etc?

Yes
No

Are you familiar with the animal control regulations in your area?

Yes
No

Are you prepared to participate in formal dog training classes to make your pet a good canine citizen?

Yes
No

Is someone home during the day?

How many hours will the puppy be left alone during the day?

Where will this PWD spend his or her time while you are gone?

Where will this PWD sleep?

Are you willing to allow us to visit your home before or after adoption? (by appointment)

Yes
No

What provisions will you make for this PWD when you go on vacation?

Questions about the dog

Do you have any preference regarding sex?

Yes
No

If YES please specify

Male
Female

Do you have any preference regarding colour?

Yes
No

If YES please specify

Do you have any preference regarding coat type?

Yes
No

If YES please specify

Curly
Wavy

Do you have any preference regarding age?

Yes
No

Would you consider an older dog?

Yes
No

If YES to what age?

Would you consider an improper coat? (may shed or cause allergic reaction)

Yes
No

Are You willing to take a PWD with a medical condition?

Yes
No

(Please understand we will choose the most appropriate puppy considering the puppy’s temperament, energy level to match your family’s lifestyle and experience. You will not be able to choose a puppy, however, your preferences will be accommodated where possible.)

References

May we check your references and verify the information you have provided?

Yes
No

If yes, provide the Name and Address of veterinarian you most often use:

Vet's Name

Vet's Address

Reference One:

Please provide the Name address, and telephone of individuals who know you and have known your other animals

Reference One Name

Reference One Address