| Name: |
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| Email Address: |
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| Phone Number: |
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| What is your physical address?
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| How many adults in your household?
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| Any children in your household? If so,
ages please: |
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| What time of dwelling do you live in?
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House
Apartment
Condo
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| Do you rent or own? |
Rent
Own
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| If you rent, the name and phone number
of your Landlord. If you own, just put N/A in this box: |
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| Have you ever owned a Boxer before?
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Yes
No
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| If no, why are you interested in owning
a Boxer? |
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| Do you have any other pets? If yes, list
them individually: |
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| Please list the name and phone number of
your current veterinarian: |
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| Have you ever had to get rid of a pet before?
If yes, please explain why: |
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| Do you have a adequately fenced in yard?
If no, how will you control your Boxer outside? |
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| How will your dog be confined when no one
is at home? |
In a Crate
Confined to a room
Loose in house
Loose in yard
In a kennel
Tied up
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| On average, how long will your dog be home
alone? |
0-4 hours
4-8 hours
8-10 hours
over 10 hours
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| What activities, if any, do you plan on
doing with your Boxer? |
Pet/Companion only
Obedience Trials
Agility Trials
Conformation Shows
Schutzhund/IPO
Herding Trials
Tracking Trials
Other performance
Breeding
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| Do you plan on breeding this dog? If yes(and
you are not involved in dog events), please explain why: |
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| What sex do you prefer? |
Female
Male
No preference
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| Will you spay or neuter this dog? If no(and
breeding it is not planned), please explain why? |
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| What color do you prefer? (check all
that apply) |
Flashy Fawn
Plain Fawn
Flashy Brindle
Plain Brindle
White
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| What age do you prefer? (select all
that apply) |
Puppy(under 4 months)
Juvenile(4-12
months)
Adult(over 12
months)
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| Are you willing to wait for your preferred
puppy? |
Yes
No
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| Have you considered adopting a rescue?
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Yes
No
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| Are you willing to purchase out of your
area or state? |
Yes
No
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| If I do not have anything available, would
you like me to forward your request to other breeders across the country?
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Yes
No
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| Please list the name and phone number of
2 personal references: |
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