RLA MAS Puppy/Dog Application

First name*

Last name*

Phone*

Email*

What are you looking for in a puppy?

Pet/Companion

Performance

Show/Breed

What is your age preference?

Puppy (8-16 Weeks Old)

Older Puppy (16 Weeks to 1 Year)

Adult (1 Year +)

Retired Adult (4 Years +)

Size Preference

Under 20 Pounds

20-30 Pounds

30+ Pounds

Gender Preference

Male

Female

No Preference

Color Preference

Blue Merle

Red Merle

Black Tri

Red Tri

No Preference

What is your time frame for receiving a new dog/puppy?

Are you familiar with the breed?

Do you have children? If yes, please list ages.

Do you have any other pets? Please list species and whether intact or neutered/spayed.

Do you have a means for your puppy/dog to obtain plenty of exercise?

Do you understand that a nonrefundable deposit is required to hold a puppy?

Yes

No

Are you over the age of 18 or do you have permission from a parent/guardian to discuss a potential new family member?

Yes

No

Other

How did you find us?

Do you have any questions?

3255744865

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