REFLECTION PUPPY APPLICATION

YOUR FIRST AND LAST NAME *

STREET ADDRESS *

CITY, STATE AND ZIP CODE *

AREA CODE PHONE NUMBER *

E-MAIL ADDRESS *

MARITAL STATIUS *

DO YOU RENT OR OWN YOUR HOME *

RENT

OWN

WHO WILL BE THE PRIMARY CARETAKER
FOR THIS PUPPY? *

DOES ANYONE LIVING IN
YOUR HOME HAVE
ALLERGIES ? *

ARE THERE CHILDREN LIVING IN YOUR HOME?
IF SO PLEASE LIST AGES. *

DO YOU LIVE IN A *

HOME

CONDO

APARTMENT

MOBIL HOME

DO YOU HAVE A FENCED YARD ?
IF SO HOW BIG IS YOUR YARD?
WHAT TYPE OF FENCE DO YOU HAVE?
WHAT IS THE HEIGHT OF YOUR FENCE? *

HAVE YOU OWNED A BOXER BEFORE ? *

YES

NO

OTHER FAMILY OWNS ONE

FRIENDS OWN ONE

DO YOU CURRENTLY OWN
ANY OTHER DOGS/PETS? IF SO,
PLEASE LIST THEIR BREED,AGE,SEX,
SAPY NEUTER STATUS. *

HAVE YOU EVER GIVEN UP AN ANIMAL
TO THE HUMAIN SOCIETY OR A RESCUE?
IF SO WHY ? *

WHY HAVE YOU CHOSEN A BOXER
AND HAVE YOU RESEARCHED THIS BREED? *

ARE YOU AWARE THAT BOXERS ARE A
HIGH ENERGY BREED ? *

YES

NO

DIDN'T KNOW THIS

WHERE WILL THIS PUPPY
SPEND DAYTIME HOURS ? *

APROX. HOW MANY HOURS A DAY WILL THIS
PUPPY BE ALONE ? *

WHERE WILL THIS PUPPY SLEEP
AT NIGHT ? *

IF A FAMILY MEMBER IS NOT ABLE
TO WATCH THIS PUPPY, WHERE WILL
IT BE KEPT ? *

DO YOU BELIEVE IN CRATE TRAINING ? *

YES

NO

IF AT ANYTIME YOU ARE NOT ABLE TO KEEP
THIS PUPPY FOR ANY REASON DO YOU
AGREE THAT THE PUPPY MUST BE
RETURNED TO THE BREEDER ? *

YES

NO

WHAT AGE ARE YOU LOOKING
FOR ? *

PUPPY

ADULT

WHAT COLOR ARE YOU LOOKING
FOR ? *

WHAT SEX ARE YOU LOOKING FOR ? *

MALE

FEMALE

DOESN'T MATTER

WHAT ARE YOUR PLANS FOR
THIS PUPPY ? *

PET/COMPANION

SHOW

BREEDING

WE REQUIRE THAT ALL PET
PUPPIES BE SPAYED/NEUTERED
AT SIX MONTHS OF AGE AND COME
WITH LIMITED AKC REGISTRATION.
DO YOU AGREE TO FOLLOW OUR
POLICY? *

YES

NO

IF WE DO NOT HAVE ANY PUPPIES
IS IT OK FOR US TO FORWARD
YOUR INQUIRY TO ANOTHER BREEDER ? *

YES

NO

PLEASE GIVE US NAME AND ADDRESS AND PHONE NUMBER FOR YOUR VET OR GIVE US TWO PERSONAL REFERANCES. *

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PLEASE TELL US ABOUT YOURSELF
AND WHY YOU AND YOUR FAMILY WOULD BE
A GREAT HOME FOR ONE OF OUR PUPPIES. THE
MORE YOU TELL US ABOUT YOURSELF AND FAMILY
THE BETTER IT WILL HELP US WITH THE PROCESS
OF SELECTING HOMES FOR OUR BABIES. PLEASE
TELL US ANYTHING YOU FEEL WE SHOULD KNOW. *