Name:
Address:
City/State/Zip:
Home Telephone: Work Telephone:
Fax: Email:
How did you hear about us?
Referred By:
Why do you want to own a Papillon?
Do you prefer a male or female? Why?
Age desired:
Would you consider purchasing a healthy, well-mannered adult Papillon (1-10 years of age)?
Primary reasons for wanting a Papillon:
Are there any traits or behaviors that would make a dog unsuitable for your situation?
Describe your home (ranch/house/condo/apartment) and the inside and outside areas to which the dog will have access:
Who will be the Papillon's primary caretaker?
Is anyone in your household allergic to animals?
Where do you intend to keep your Papillon? (Indoors/Outdoors/Both)
How will the Papillon be safely confined to your property? If fenced, height and type of fence:
How many hours per day will your Papillon be alone? (no one home with dog)
Are you willing to have one of our representatives inspect your premises prior to adoption?
Because housebreaking a new pet can take weeks or even months, does your new dog have to be housetrained or are you willing to train it with positive reinforcement/humane methods?
What are your plans for training this dog, e.g. puppy socialization classes, obedience classes, private trainer, etc.?
Please describe the area to be provided for this dog to eliminate
Do you have any pets at the present time? Species, Breed, Age Species, Breed, Age Species, Breed, Age Species, Breed, Age Species, Breed, Age
Have you had other pets in the past and if yes, what happened to them?
Please list persons living in your home: Name, Relationship, Age (if child): Name, Relationship, Age (if child): Name, Relationship, Age (if child): Name, Relationship, Age (if child): Name, Relationship, Age (if child):
Please list any questions you have regarding Papillons such as breed characteristics, temperament, grooming, care, etc.
Please provide a minimum of three references who are familiar with your family, lifestyle and home. If possible, please include your vet as a reference as well. Name, Phone, Email Name, Phone, Email Name, Phone, Email Name, Phone, Email Name, Phone, Email
How long have you been looking a Papillon?
Have you investigated other sources for a Papillon? (e.g. other reputable show breeders, backyard breeders/newspaper ad, shelters, pet store)
Have you investigated the Papillon Club of America Web Site at http://www.papillonclub.org/ ?
Have you considered a rescue and checked out the Papillon Club of America's Rescue Web Site at http://www.papillonclub.org/rescue ?