Last Name:
First Name:
Address:
City: State: Zip code:
E-mail:
Phone Number(s) If it is all right for us to contact you at work, please include the contact number :
Home: Work:
A good time to call, if we need to reach you:
How were you reffered to us?
Are you interested in (please check box(s)):
Puppy Older, trained dog Rescue
Male Female No Preference
Pigmentation(s) desired (please check box(s)): (FLASH is WHITE markings, no
Fawn/black mask Brindle-light/black mask Brindle-light/black
Fawn/black Brindle/black mask Brindle/black
White Brindle reverse/black Brindle-reverse/black
Additional information you would want us to consider:
Why are you interested in obtaining one of our boxers?
Agility Companion Obedience
Protection Show/breeding
Other:
What qualities do you like/dislike about the Boxer breed?
Is this your first Boxer? Yes No
Previous dogs:
What animals do you have now?
Have you examined our sales policy? Sales Policy )
Yes No
Are you committed to caring for this dog for its lifetime, the next 8-12 years sometimes longer. If any
Electronic legal signature:
Have you ever had to euthanize an animal? Yes No
If yes, why?
Name of your veterinarian:
Address:
Phone Number:
All pet quality dogs are sold with limited AKC and UKC papers. Spaying or neutering is required.
Please provide three personal references that we may contact: (you may want to let them know we
1. Name:
2. Name:
3. Name:
Family Data:
Are you: Single Married Divorced Widowed
Number of children, age(s), or are you planning a family, or others in the household that will
Occupation(s) of adult(s) in family:
Where will the dog stay during the day?
Do you live in (please check one): Urban Suburban Rural
Do you (please check one): Own Rent
Further information that you feel we should consider:
Please use this space to make comments or to ask any questions.