| E-mail Address: * |
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| How many people live in your household? |
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| How many children live in your household? |
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| What are their ages? |
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| Describe your yard. Is it fenced? Puppy friendly? |
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| Is someone home during the day to care for the puppy? If not, what arrangements will you make for the puppy? |
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| How many hours per day will puppy be left alone? |
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| Are you planning on breeding your puppy in the future? |
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| Have you considered the expenses that come with owning a puppy/dog? |
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| Tell us about you and why you would like to add a puppy to your family |
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| Do you have any other pets? How many? |
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| Which are you interested in, a Cockapoo or Cocker Spaniel? |
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| Are you interested in a fall or spring litter? |
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| Do you prefer a male or female? |
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| Do you have a color preference and if so, what color? |
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| Do you agree not to place this pup/dog in an animal shelter at any time in the future? |
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| Contact name & phone number |
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| * Required |
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