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Perspective Pet Parent(s) Information
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Last name(s):
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First name(s):
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Address NO PO BOXES Please
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City
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State
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Zip Code
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E-Mail Address:
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Primary Phone:
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Secondary Phone:
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Own
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We may need a copy of your mortgage statement or tax bill
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Housing, Do You
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We need a letter from the landlord or a copy of your lease stating that pets are allowed
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Rent
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How did you hear about us?
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FaceBook
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Web Site
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Friend
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Ad
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Other
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If NO, please tell us how many you have/had and their age and sex
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Yes
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Will this be your first Chihuahua?
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No
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Do you own any other animals, other than Chihuahuas?
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No
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Yes
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If Yes, Please tell us how many, what breed, and their ages
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No
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Have you researched the breed?
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Yes
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Do you currently have a Veterinarian?
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Yes
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No
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If Yes, the Veterinarian's Name
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Phone #
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How many hours a
day will the puppy
be crated?
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How many hours a day will
the puppy be left alone?
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How many humans live in the home?
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Childrens age groups if any
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Is everyone in the home in
agreement with getting a new puppy
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Yes
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No
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Press Ctrl and click if multiple groups
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Do you have a specific puppy in mind?
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Yes
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If yes, Which puppy?
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No
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Do you have a preference as to the sex of the puppy?
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Male
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Female
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No Preferance
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Do you have a color Preference?
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No any color
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I prefer
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We breed both AKC and CKC Pure Breed
Chihuahua's, Do you have a preference?
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AKC
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CKC
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No Preference
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Yes
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If no, are you willing to sign
a spay / neuter contract?
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Do you plan on breeding this Chihuahua?
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Yes
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No
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No
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If Yes, please explain so we know more about you such as?
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Yes
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No
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Do you have a website?
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If yes, please list your URL:
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Are you state licensed?
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If yes, State and
License Number
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Yes
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No
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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 type your name (s) below
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Full Name
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Full Name
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By submitting this form you agree that you answered all the questions truthfully
to the best of your knowledge. Any false information entered can cause this
form to be void and any deposit placed on a puppy to be forfeited.
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