Wit's End Puppy Application

Date

MonthDayYear
DateHourMinutesAM/PM Option
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Email*
example@example.com
Phone Number*

Area CodePhone Number
Best Time to Call*

:HourMinutesAM/PM Option
YesNo
YesNo
HouseApartmentCondominiumDuplex/Triplex/QuadplexGarage/Studio ApartmentMobile HomeOther
OwnRent
YesNo
Landlord's name and contact info, including address, phone, email, etc:
If you move, what will you do with this dog?
Less than 1 year1 to 3 years3 to 5 yearsMore than 5 years
If less than 1 year, please give complete previous address:
YesNo
If yes, what is the height and type of fence?
YesNo
If living in an apartment, what arrangements do you plan to make for exercise and toilet duties?
YesNo
YesNo
Please provide 2 personal references with phone numbers and emails:
How many adults live in your home?
MarriedSingleUnmarried, but living with Significant OtherRoom mateOther
If you have room mates, how many?
YesNo
If yes, please give their ages and a brief history of their dog experiences:
YesNo
If so, what are their ages and their experience with dogs?
YesNo
Who will be the primary caretaker?
YesNo
If yes, what breed(s):
Please give a brief pet owning history, ie: health care, including heartworm preventative, vaccinations, etc:
YesNo
If yes, please provide your veterinarian's name, address, phone number and date of last visit:
YesNo
If yes, please give the name, breed, sex, and age of each:
YesNo
If the answer is no, please explain why not:
How many pets have you owned in the past 5 years?
If you no longer have them, please give details explaining what happened to them:
If you have had a pet die at an early age or have ever lost a pet, please provide details:
YesNo
If yes, please explain:
YesNo
If yes, please explain:
YesNo
Why do you want a Boxer?
FemaleMaleNo preference
What is your color preference (check all that apply)?

Plain BrindleFlashy BrindlePlain FawnFlashy FawnWhiteNo Preference
Puppy (2-6 months)Juvenile (6-18 months)Adult (over 18 months)No Preference
1-3 Months3-6 Months6-12 Months1 Year or MoreHowever long it takes
YesNo
YesNoType option 3Type option 4
Where will your dog spend most of his day? Check all that apply and explain 'Other'.

Loose IndoorsLoose outdoors in fenced yardCrateBasementGarageKennel RunTied or chained outsideOther
Where will the dog be when you are away from home during the day (check all that apply and describe 'other')?

Loose IndoorsLoose outdoors in fenced yardCrateBasementGarageKennel RunTied or chained outsideOther
12-44-66-88-1010-12
What arrangements have you made for puppy care during the day when you are not at home?
Where will the dog spend the night (check all that apply and describe 'other')?

Loose IndoorsLoose outdoors in fenced yardCrateBasementGarageKennel RunTied or chained outsideOther
YesNo
YesNo
If yes, where:
YesNo
YesNo
YesNo
YesNo
What is your GOAL for this dog? Check all that apply and explain 'Other'.

Well-behaved house petFuture championCompetitive obedience dogCompetitive agility dogTherapy/assistance dogHerding/tracking dogOther
YesNo
YesNo
If NO, please explain:
YesNo
YesNo
Comments, questions or additional information:
Signature*
Check the Box!*
Should be Empty: