Puppy Questionnaire
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Puppy Questionnaire |
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Date: __________ Litter
of Interest: Future Litter State which one ____________ Puppy Preference: __ Male - __Female
- __Either - __Will accept Opposite Sex Your Name: __________________________________________ Street Address: ____________________________________ ____________________________________ Type of Residence: Single
Family Home or Apartment (circle) Phone Number - Home: _____________
Work: ____________ Family Status: __Single
__Married - Spouse Name: _______________ ________________________________________________________________________________________ _______________________________________________________________________________________ Canine Experience: List dogs currently owned
: _________________________________________________________________ List dogs previously owned and disposition of each: _________________________________________________________________ _________________________________________________________________ Has any of your dogs ever ended up in rescue or
APL situation? Are you currently a member of any organization or
club? __Yes or __No Do/will your dog(s) live: __In Home __Outside
__Fenced Yard __Kennel Plans for said puppy - Check all applicable: __Pet/Companion __Breeding
Training: __ Yes or __ No References: List two persons that can verify
your good character and canine experience if applicable (include phone number): ______________________________________________ Please List Your Vet and Phone Number___________________________
_________________________________________ Please use the space below to add
any other information you would like us to know about you or other comments: ________________________________________________________ ________________________________________________________ ________________________________________________________ Thank You for your interest in a Bear Creek mastiff puppy! Please Email to: or mail to: Donna
Imbierowicz Bear Creek English Mastiffs 105 Fernwood Road Coatesville, PA 19320
Puppy Questionnaire Date: __________ Litter
of Interest: Future Litter State which one ____________ Puppy Preference: __ Male - __Female
- __Either - __Will accept Opposite Sex Your Name: __________________________________________ Street Address: ____________________________________ ____________________________________ Type of Residence: Single
Family Home or Apartment (circle) Phone Number - Home: _____________
Work: ____________ Family Status: __Single
__Married - Spouse Name: _______________ ________________________________________________________________________________________ Canine Experience: List dogs currently owned
: _________________________________________________________________ List dogs previously owned and disposition of each: _________________________________________________________________ Has any of your dogs ever ended up in rescue or
APL situation? Are you currently a member of any organization or
club? __Yes or __No Do/will your dog(s) live: __In Home __Outside
__Fenced Yard __Kennel Plans for said puppy - Check all applicable: __Pet/Companion __Breeding
Training: __ Yes or __ No References: List two persons that can verify
your good character and canine experience if applicable (include phone number): ______________________________________________ Please List Your Vet and Phone Number___________________________
_________________________________________ Please use the space below to add
any other information you would like us to know about you or other comments: Thank You for your interest in a Bear Creek mastiff puppy! Please Email to: or mail to: Bear Creek English Mastiffs 105 Fernwood Road Coatesville, PA 19320 Thank you for your interest
in applying for a beautiful Bear Creek puppy!
Puppy Questionnaire
Date: __________ Litter of Interest:
Future Litter
State which one ____________ Puppy Preference: __ Male - __Female - __Either -
__Will accept Opposite Sex Your Name: __________________________________________ Street Address: ____________________________________
____________________________________ Type of Residence: Single Family Home or Apartment
(circle) Phone Number - Home: _____________ Work: ____________ Family Status: __Single __Married - Spouse Name: _______________ ________________________________________________________________________________________ Canine Experience: List dogs currently owned : _________________________________________________________________ List dogs previously owned and disposition of each: _________________________________________________________________ Has any of your dogs ever ended up in rescue or APL situation? Are you currently a member of any organization or club? __Yes or
__No Do/will your dog(s) live: __In Home __Outside
__Fenced Yard __Kennel Plans for said puppy - Check all applicable: __Pet/Companion __Breeding Training: __ Yes or __ No References: List two persons that can verify your good character and canine
experience if applicable (include phone number): ______________________________________________ Please List Your Vet and Phone Number___________________________
_________________________________________ Please use the space below to add any other information you
would like us to know about you or other comments: Thank You for your interest in a Bear Creek mastiff puppy! Please Email to: or mail to: Bear Creek English Mastiffs 105 Fernwood Road Coatesville, PA 19320 Thank you for your interest in applying for a beautiful Bear Creek puppy!
Puppy Questionnaire
Date: __________ Litter of Interest:
Future Litter State which one ____________ Puppy Preference: __ Male - __Female -
__Either - __Will accept Opposite Sex Your Name: __________________________________________ Street Address: ____________________________________
____________________________________ Type of Residence: Single Family Home
or Apartment (circle) Phone Number - Home: _____________ Work: ____________ Family Status: __Single __Married - Spouse
Name: _______________ ________________________________________________________________________________________ Canine Experience: List dogs currently owned : _________________________________________________________________ List dogs previously owned and disposition of each: _________________________________________________________________ Has any of your dogs ever ended up in rescue or APL situation? Are you currently a member of any organization or club?
__Yes or __No Do/will your dog(s) live: __In Home __Outside
__Fenced Yard __Kennel Plans for said puppy
- Check all applicable: __Pet/Companion __Breeding Training: __
Yes or __ No References: List two persons that can verify your good character
and canine experience if applicable (include phone number): ______________________________________________ Please List Your Vet and Phone Number___________________________
_________________________________________ Please use the space below to add any other information
you would like us to know about you or other comments: Thank You for your interest in a Bear Creek mastiff puppy! Please Email to: or mail to: Bear Creek English
Mastiffs 105 Fernwood Road Coatesville, PA 19320 Thank you for your interest in applying for a beautiful Bear Creek puppy! Puppy Questionnaire Date: Litter of Interest: Future Litter State which one ____________ Puppy Preference: Male - Female - Either - Will accept Opposite Sex Color: Brindle Apricot Fawn No Preference Your Name: (Complete as name to be shown on Registration including co-owner if any) Street Address: City: State: Zip Code: Type of Residence: Single Family Home or Apartment (circle) Phone Number - Home: Work: E-Mail Address: Family Status: Single Married - Spouse Name: Children Living at Home: Yes No Names and Ages: Canine Experience: List dogs currently owned : List dogs previously owned and disposition of each: Has any of your dogs ever ended up in rescue or APL situation? Are you currently a member of any organization or club? Yes or No Do/will your dog(s) live: In Home Outside Fenced Yard Kennel Other: Plans for said puppy - Check all applicable: Pet/Companion Breeding Obedience Agility Conformation Other Training: Do you anticipate sending your puppy away to a puppy socialization class Yes or No References: List two persons that can verify your good character and canine experience if applicable (include phone number): Please use the space below to add any other information you would like us to know about you or other comments: Please Email to: donnabear@ccis.net or mail to: Bear Creek English Mastiffs 105 Fernwood Road Coatesville, PA 19320 Thank you for your interest in applying for a beautiful Bear Creek puppy! |
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