subject_line
Havanese Puppy Application
First Name
*
Last Name
*
Email Address
*
Telephone (Optional)
Street Address (optional)
City / Town
Province
*
Postal Code
Do you have children?
*
Yes
No
What age are your children?
0 - 5 years
6 - 10 years
11 years and older
Does anyone in your home have allergies?
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Yes
No
If yes, tell me about them?
What is the activity level of your household?
*
Low - Couch Potatoes
Moderate - Happy Go Lucky
High - Get Up and Go
Do you live in a:
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House
Townhouse
Condo
Apartment
Mobile Home
Do you own or rent your home?
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Rent
Own
If renting do you have permission to have a dog?
Do you have a fenced in yard?
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Yes
No
Have you ever owned a pet?
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Yes
No
What kind of pets?
Dog
Cat
Bird
Fish
Other
If yes, tell me about them?
Why do you think the Havanese breed is best suited for you and your family?
*
Do you have a gender preference?
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Male
Female
Doesn't matter
If you have a preference, please tell me why?
What activities would you like to do with your dog? You can choose more than one!
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Daily walk will be enough for me
A good game of fetch in the backyard
Conformation showing
Obedience Training and showing
Rally Obedience
Fly ball
Agility
Other
Do you work outside of the home?
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Yes
No
How many hours on average will the dog be left alone during the day?
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0 - 2 hours
3 - 4 hours
5 - 6 hours
7 - 8 hours
Where will the puppy be when you are not at home?
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Where will the puppy sleep at night?
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How would you handle the puppy's behavior issues like chewing on your shoes or furniture?
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We strongly recommend taking the puppy to puppy socialization classes and obedience classes with positive training methods. Have you attended obedience classes with a dog?
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Yes, I have a trainer / classes in mind that use positive methods
Yes, But it has been awhile, will need help finding a trainer / classes in my area
No, I have never been to classes but I know of a trainer / classes in my area
No, I will need help finding a trainer / classes in my area
What do you think are the most important ways to keep a dog happy, and well behaved?
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Is there anything else you would like to tell me about yourself or why you would like to have a Havanese?
Do you have a Veterinarian?
*
Yes
No
If yes, Vet's Name and Address
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