Cinergy Boxers Puppy Application

Complete the following questionnaire if you are interested in being considered as a potential puppy purchaser:

* Name:

Address:

City:

State:

Zip:

Home Phone:

Work Phone:

Occupation:

* Email:

The best time to reach me is:

1. Do you own or rent your home?

2. How long have you lived at this address?

3. How large is your yard/or how many acres?

4. Do you have a fenced yard?

5. If so, what type of fencing?

6. If you do not have fencing, how will you handle the puppy's exercise and toilet duties?

7. How many adults and children in household?

8. Ages of children?

9. Do you own other dogs?

10. If yes, describe breed, sex, and age:

11. If you own other dog(s) are they neutered or spayed?

12. If you own cats are they declawed?

13. Have you owned a Boxer before?

14. Why did you choose this breed?

15. What is your color preference?

16. Do you want a "Male" or Female"?

17. How many dogs have you owned in the last ten years?

18. If you have owned dogs in the last ten years that are not presently living with you, what happened to dog(s) and be specific:

19. Will the puppy reside in the house?

20. If you work how will the puppy spend its days?

21. How will the puppy spend the night? Crated or uncrated?

22. How many hours on the average will the dog spend alone per day?

23. List all plans for this dog:

Pet Guard Herding Obedience

Breeding Conformation Agility Other

24. Please provide any additional comments you would like to make:

All puppies not sold, as Show/Breeding Potential will go on Spay/Neuter contracts.

* Indicates Response Required