Name           
                                                                                          
            Address     
                              
                              
                              

            Email Address 
  
            Home telephone #

            Work telephone #

            Current occupation

            Marital Status  

            Name of spouse/roommate/significant other that resides with you  

            Occupation

            Children? Ages? Live with you?
                                                            
                                                              
          
            Does anyone in your family or household have allergies to animals?  Yes   No

            Do you own or rent  your home?

            If you rent your home, are you allowed pets?  Yes    No

            Is there a weight limit on pets or other restrictions?   Yes     No

            Type of home?    House    Apartment     Mobile Home    Other

            Does your home have a yard?  Yes   No         Is it fenced?   Yes No

            How (chain link, etc)?

            Do you plan to use an invisible fence to contain the dog?   Yes   No

            Is anyone at home during the day?   Yes    No

            Where will the puppy stay during the day?

                                                              At night?

            Have you owned a dog previously?   Yes    No      How many years?

            Still own? Yes No If no, make a selection It died from old age It died from a disease (please give details in the comments box) It was hit by a car It was stolen It ran away I gave it away Other (please give details in the comments box)

            Have you owned a Labrador previously? Yes  No   Another breed Retriever?  Yes  No

            What other pets share your home? 

            Describe your lifestyle (i.e.: active, outdoors type, moderately active, etc.) 

            You would like this puppy to be a (i.e.: companion dog, gun dog, SAR, etc) 

            You prefer your puppy to be   Male   Female

            You prefer your puppy to be   Black  Chocolate   Yellow          

            Are you willing to accept a puppy of a different color or sex if your preference is not available?  Yes   No

How much are you planning to spend to acquire a well bred puppy?

            Do you plan to breed this puppy?   Yes  No

            Our puppies are sold on an AKC Limited Registration.
            This means any litters produced by this puppy cannot be registered unless we agree to change the registration to Full. 
            We are willing to change the registration to Full once all of the puppy's health clearances have been obtained. 
            Are you willing to accept this?   Yes   No

            Will you pick up this puppy or have it shipped ?

            If you choose to ship the puppy, what is the closest large airport to you?

            Would you like to be placed on our waiting list for the next available litter?  Yes   No

Comments