Puppy Application
Bella's Little Angels Chihuahua Breeder


First and last name of adoptive parents: ______________________________________________
: ______________________________________________
Complete physical address (NO PO. Boxes) Street Address:
_________________________________________________________________
City, State, Zip: ________________________________________________________________
Mailing address if different from physical address:
Street Address: _________________________________________________________________
City, State, Zip: ________________________________________________________________
Home Phone #: (_____) _______-___________ Cell #: (_____) ________-________________
Email address: _________________________________________________________________
Do you own or rent?________________ If you rent, we need a letter from the landlord or a copy of your lease stating that pets are
allowed. If you own, we need a copy of your mortgage statement or tax bill.
How did you hear about Bella’s Little Angels: Friend:__________________ Ad: ___________________ Another Website:
_________________________________________
Will this be your first Chihuahua? Yes No If no, please tell us how many you have and their sex & age Males ____ Females _____ Long
Coats ______ Short Coat _________ If yes, have you researched the breed: Yes No
Do you currently have a Veterinarian? Yes No if NO, you must have one prior to picking up the puppy If yes, Vet name:
_________________________________ and phone number: (______) _________-_____________
How many hours a day will the puppy be left home alone? ______________ What pets do you currently own?
List all animals in your residence full or part time.
_______________________________________________________________________________________________

_______________________________________________________________________________________________

How many other humans live in the home? ________ If children, their ages: _____________________________
Is everyone in the home in agreement with the puppy?:_________________________________ Do you have a specific puppy in mind:
Yes No If yes, which one_____________________________________
Do you have a preference as to the sex your new puppy will be? Male Female Either Do you have a color preference:
1:_____________________ 2:__________________ 3:_______________ None
All of our Chihuahua puppies are purebred, are you looking for AKC CKC No Preference
Do you plan on breeding the Chihuahua that you purchase from us? Yes No
If yes, please explain so we know more about you such as: Do you have a website? Yes No If yes, please list your URL
________________________________________
Kennel or Hobby Name:___________________________________________________________________________
Are you state licensed?: YES NO
How long have you been breeding or thinking about breeding? ___________
If NO, are you willing to sign a spay / neuter contract YES NO _____________


This application is just that, an application. It does not constitute a sale or hold of a puppy. No puppy will be placed on hold until this
application is approved by the breeders Becky and Don D’Allaird. The placement of our puppies is the most important part of our
business. Our goal is to ensure that each of our families are completely educated on the commitment and responsibility that a new
Chihuahua puppy requires and have the resources required to care for a new puppy. I / We understand that by signing this application
it does not guarantee me the purchase of a puppy or to be placed on a waiting list. I / We also understand that the breeders Becky and
Don D’Allaird have the final say as to whether to approve or deny the application. The breeders Becky and Don D’Allaird will notify you
within 96 hours of receiving this application as to its approval status. Please sign or type your name (s) below
Name: _______________________________________________ Date: ___________________________ Signature:
_________________________________________________________________________________ Name:
_______________________________________________ Date: ___________________________ Signature:
_________________________________________________________________________________
Please do not write in the space below. This space is for use by Bella’s Little Angels. Rental property verified as to allow pets or home
ownership verified? Approved Declined
Why?: ______________________________________________ Vet information verified? Approved Declined
Why? _______________________________________________ Application Approved Declined
Why? _________________________________________________ Signed____________________________________________
Date_______________________________ Bella’s Little Angels
Copyrighted 2007 - 2017  Bella's Little Angels
All Rights Reserved
NYS Inspected
AKC Inspected
Counter