Puppy Form

Name: Address: Phone (home): work:

Referred by:

What reference materials have you read? How many individuals of this breed are you acquainted with?

Type of dwelling: house apartment mobile home

If renting, please give name and address of landlord:

Name, address and phone number of your veterinarian:

Who will be the primary care giver?

Where will the puppy be kept during the night?

Where will the puppy be kept during the day?

Is anyone home during the day?

How many hours on the average will the puppy be left alone?

Will there be someone available to feed and exercise the puppy during the day?

Have you ever owned a dog before?

Do you have any other animals?

Do you have any children? If yes, what are their ages.

Does anyone in your household have allergies to animals?

If yes, to what and how severe?

Are you interested in a male or female puppy?

At what age do you wish to get the puppy?

Have you considered an older dog instead of a puppy?

How did you bear about this breed?

What do you expect the activity level of this breed to be: very high high moderate below average

What kind of floor surfaces will the dog be on in the house?

How many hours a day will the puppy be kept outside?

How will he be confined when he is outside?

Do you have a fenced yard or suitable pen?

Have you ever house trained a dog before?

How long have you lived at this address?

Will you be attending any training classes?

If yes, at what age will you start, which activities or competitions are you interested in, who is the trainer?

How long did your last pet live? What were the circumstances of its' death?

Have you ever returned a pet to the breeder? If so, what were the circumstances?

Have you ever given a pet away? If so, what were the circumstances?

Have you ever taken a pet to a pound or shelter? If so, what were the circumstances?

Are you interested in showing the dog in the Show ring?

Have you ever shown a dog to it's championship?

Would you purchase only to use the dog at stud

What tests have you undertaken before a stud / Bitch is mated. And Pedigree Purusal

Do you understand the endorsements (R) (X ) placed on the KC registration

Would you consider a fawn / Bitch and black dog Mating.

You are the ones who would like to own a Jessygaff Pug. You are the ones who have to do all the hard work.

So please provide us with as must information as you can about your present pets, showing, home, future plans.

We will only place one of our puppies into a home that we are more then 100% happy with.

We look forward to hearing back from you.