Puppy Application

This application is to assure that I have your best contact information and you have mine. I prefer to text or call me rather than email.  

 I will do my best to respond within 24-48 hours. 

If you are waiting for future litters, please fill out the application so I can keep you up to date!

Name: (required) 

First Name ___________________________________________________   Last Name _____________________________________________________________________________

Email Address: (required) ______________________________________________________________________________________________________________________________

Confirm Email Address: (required) _____________________________________________________________________________________________________________________

Phone Number: (required) ______________________________________________________________________________________________________________________________

Please enter a phone number that I can reach you at via text, I send lots of pictures via text: ________________________________________________________

Confirm Phone Number: (required) ______________________________________________________________________________________________________________________

Address: (required) _______________________________________________________________________________________________________________________________________

City: (required) ____________________________________________________________________________________________________________________________________________

State: (required) ___________________________________________________________________________________________________________________________________________

Zip Code: (required) _______________________________________________________________________________________________________________________________________


How did you hear about Becky's Bernese Mtn Dog Puppies? _____________________________________________________________________________________________

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What gender of puppy are you looking for?: (required) ___________ 

Would you plan to breed this dog?: (required) ____________

Would you spay/neuter this dog?: (required) ________________

Have you ever raised a puppy?: (required) ___________________________________________________________________________

Do you have any other dogs right now?: (required) ____________________________________________

If so, what are the breeds? _________________________________________________________________

How do you plan to get your puppy?: (required) ___________________________

Home Life

How many people currently live in your household?: (required) _________________________

Do you have any children?: (required) ______________________

If so, what are their ages? ____________________________

Is someone in your household home during the day?: (required) _____________________________

If not, where will your dog be kept while you are out? ___________________________________________
 
Do you have a fenced yard or other enclosure for a dog? If so, please describe: (required) __________________________________________________________

How interested are you in adopting a puppy?: (required) _____________________________________________________________________________________________

Looking around Interested in a few months and I want more information: ___________________________________________________________
I am looking around, but am ready to adopt: __________________________________________________________________________________________
I have found the puppy I want and am ready to adopt: ________________________________________________________________________________
You must agree to provide your dog with proper housing, food and veterinary care for its lifetime: (required):   I agree

You must confirm that you are at least 18 years of age: (required) SIGN: _____________________________________________
I confirm that I am 18 years or older.

What questions do you have for me? __________________________________________________________________________________________________
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