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Puppy Application

State
Marital Status
Married
Single
Divorced
Widow/Widower
Undisclosed
Age Group
Under 18
18-30
31-50
51-65
Over 65

Living situation

Where do you live?
House
Apartment
Duplex
Condo
Other
Location of Dwelling
Rural
City
Small Town
Do you rent or own?
Rent
Own
If you rent, are you planning to purchase your own home in the near future?
Yes
No
If you are renting, do you have your landlord's permission to own a dog?
Yes
No
Can you provide a letter stating such from your landlord?
Yes
No

Work History

Family Information

Number of children living in the home:
None
One
Two
Three
More than three
Are they comfortable around dogs?
Yes
No
If no, have they had a bad experience around dogs?
Yes
No
Does anyone in the household have allergies to dogs?
Yes
No
Does everyone in your household want to get a Cocker Spaniel?
Yes
No
Can you provide us with references if we should ask for them?
Yes
No

Dog Experience

Do you currently own a dog?
Yes
No
Are there any other pets in the home? (cats, hamsters, etc.)
Yes
No
Do you have previous dog ownership experience?
Yes
No
Is proper veterinary care and a high quality diet a priority?
Yes
No
Are you concerned about the health and over-vaccination in pets?
Yes
No
Are you willing to follow the vaccination protocol recommended by the breeder?
Yes
No
Do you have a preference of puppy gender?
Male
Female
I'm happy with either (no preference)
Are you planning to add any other pets to your home in the near future?
Yes
No
Maybe

Why a Cocker Spaniel?

Have you met a Cocker Spaniel in person?
Yes
No
What kind of energy level are you looking for?
High
Medium
Low
Will this dog live at the supplied address?
Yes
No
Where will this dog spend most of its time?
In the house
Fenced yard
Outdoor kennel
Tied up outside
Where will this dog generally spend its time when you are working or away from home?
With me
At home inside
At home outside
Do you have a fenced yard?
Yes
No
Not currently, but I plan to
How much time would the dog normally spend alone at home each day?
0-3 hours
3-5 hours
5-8 hours
8 or more hours
How many days a week would the dog be home alone?
Are you currently on a waiting list from another Cocker breeder?
Yes
No

Thank you for taking the time to answer the questions in our application. By providing us with this information, we hope to better understand why you want to add a Cocker Spaniel to your home, and if we have a Cocker Spaniel that will fit your needs. All information is treated with the upmost confidentiality and will not be passed along to anyone without your permission.

Debra Allen - Justice Kennels - established 1990

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