PUPPY ADOPTION APPLICATION

APPLICANT'S CONTACT INFORMATION:

Name:

Address:

City:                                       State:               Zip:                           Home phone:

Cell or other phone:

E-mail address:

Best time to contact you:

HOUSEHOLD ENVIRONMENT:

Number of adults:

Number of children and ages:

Past pet ownership history:

Current pet ownership:

Family lifestyle: active, moderate or quiet

Will someone be home with your new puppy?

         If yes, who?                                                                               If yes, when?

Facility for puppy: Yard, Fenced Yard, Pond/Lake, Acreage, Crate, Park, Unsure

Reason for wanting a Golden Retriever:

DESIRED PUPPY QUALITIES:

Write your 1st, 2nd, and 3rd choices in the blanks provided:

1st-2nd pick male ($1,800) _______  3rd-4th pick male ($1,700)  5th-6th pick male ($1,600)

1st-2nd pick female ($2,000) ______   3rd-4th pick female ($1,900)   5th-6th pick female ($1,800)

Note: Final pick will depend up puppies available.

Estimated Size at Maturity: Small (50-65 lbs.), Medium (65-75 lbs.), Large (75-85+ lbs.), Doesn't matter

Puppy's Energy/Activity Level: Active, Moderate, Quiet, Doesn't Matter

Dog's Intended Use: Pet, Hunting, Show

A $250 deposit is due to reserve your puppy.  The remaining balance is due at pickup or before puppy is shipped to its new owner.

       Choose preffered payment options for the $250 deposit: Check, Cash, Bank money order, Paypal (3.25% additional fee),payment plan

     Choose preffered payment options for the REMAINING BALANCE: Check, Cash, Bank money order, Paypal (3.25% additional fee), payment plan

Preferred Delivery Options: Pick up at kennel, Local (free delivery), Pay ground transport, Pay air shipment, Not sure.

How Did You Hear About Us? Nextdaypets.com, puppydogweb.com, breeders.com, puppyfind.com, Pet-classifieds.com, friend, other: ____________________________________________

Would You Like To Be Contacted as Our New Litters Are Born? Yes, No

Other questions or conersn: _______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________

_______________________________________________________________________________________