Puppy Application

Please provide the following contact information:

 
 
 
 
 

First name
Last name
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
Work Phone
Home Phone
FAX
E-mail
URL

Why do you want a collie?

Do you have any pets currently?

Yes  No 

What kind of pets do you currently have?

Do you plan on showing your new puppy?

Yes  No 

Please list all animals that you have had in the past five years and what happened to them.

Please list the name and address your Veterinarian

If you do not plan to show your puppy do you agree to spay/neuter your pup?

Yes  No 

If for some reason you had to give up your new puppy would you agree that the pup comes back to Countryhaven?

Yes  No 

Do you have a fenced in yard?

Yes  No 

If you do not have a fenced in yard how do you plan on exercising your puppy daily?

What do you think the cost per year will be for the maintenance of your new puppy?