Our puppies are placed in approved homes only so we would like to get to know you and your family better. We appreciate you taking the time to fill out this questionnaire completely. (Many of our questions only require a yes/no or one word answer.) Filling out this questionnaire does not obligate you to buy a puppy, nor does it guarantee you will be approved. Please be honest, as there are no right or wrong answers. This will allow us to find the right puppy for your family. Also, please be assured that all of the information you give will be kept completely private and secure. The cost for a puppy from the next litter will be $1,800  

  **In order to complete this questionnaire online, please copy and paste it into an e-mail and fill in the blanks using your e-mail program. Please send the completed application to NYPugPups@hotmail.com

  

Applicant #1 

Name: _____________________________________________

Address: __________________________ City: _______________________ State ______ Zip ________

Phone #’s

Home: ___________________

Work: ___________________

Cell: ___________________

E-Mail: _______________________________________

Occupation: ___________________________________________________

Age: ____________ *Must be 18 or over to purchase and sign contract

 

 

 Applicant #2 (If any) 

Name: _____________________________________________

Address: __________________________ City: _______________________ State ______ Zip ________

Phone #’s

Home: ___________________

Work: ___________________

Cell: ___________________

E-Mail: _______________________________________

Occupation: ___________________________________________________

Age: ____________ *Must be 18 or over to purchase and sign contract

Relationship to applicant #1 ________________________________

 

Do you live in a: House Townhouse Condo Co-Op Apt Other? ______________

Do you Own or Rent? ________________________

If renting or bound by the rules of a Condo/Co-OP, do you have permission from the owner/board to have a dog? ___________ Can you provide written proof w/owner’s or board’s contact information? __________________________________________________________________________________

How long have you lived at this residence? _________________

Do you have any children? ___________ If yes, please tell us about them. (Names ages, sex)

Do you or someone in your house have severe allergies or asthma? __________

Are you aware that dogs shed lots of hair year round? _______

Are there any major changes expected in your family? (Moving? Pregnancy? Etc.) _____________

Do all family members want a new puppy? ___________

Who will be the primary caregiver for the Pug? ________________________________

Who will train the Puppy? _______________________

Have you ever owned a dog in the past? _______ If so, what breeds? ______________________________

How old were these dogs when they died and what was the cause? ________________________________

Have you ever had to give up a pet to a shelter or return to a breeder? _______ If so, please explain why?

 

 

 

 

 

Have you ever had a pet Euthanized? _______ If so, why? _____________________________________

Have you ever owned or housed a dog with a communicable disease such as parvo, distemper, rabies, ringworm or suspected to be such? _______ If so, when? ______________________________________

Do you currently have any pets? _______ If yes, how many, what kind, and breeds? Please include age, sex, spayed/neutered or intact. _____________________________________________________________

______________________________________________________________________________________

What made you want a pug? _______________________________________________________________

Do you want a male or female? _________________________________

What color do you want? _____________________________

For what purpose are you purchasing a pug? (choose all that apply) Family pet, Obedience, Show dog, Breeding, Agility, Tracking

_______________________________________________

What kind of temperament are you looking for in a dog? ________________________________________

Which characteristics do you hope to avoid? __________________________________________________

What research have you done on the temperament, characteristics, and health issues/needs of the Pug breed? ________________________________________________________________________________

Have you spent time with any Pug dogs to determine if the breed is right for you? _______ If yes, please explain _______________________________________________________________________________

Do you have a regular veterinarian? _______ If yes, please provide name and phone number.

_____________________________________________________________________________________

**Puppies need to be trained. They will not automatically know how you want them to behave. Training takes A LOT of patience. Do you realize this and are you willing to commit to working through behavioral problems? ________

Do you plan on crate training your puppy? _______ If no, why not? ____________________________________________________________________________________________________________________

Are you willing to take your new puppy through a puppy kindergarten and a basic obedience class with a certified trainer? __________

Do you have a trainer that you currently use or have used in the past? _______

How much time will you be able to devote to socializing your new dog? ____________________________

How many hours each day will your Pug puppy be left alone? ____________________________________

Where will your new puppy stay during the day when alone? _____________________________________

Where will your new pug sleep? ___________________________________________________________

Do you know that a Pug requires and demands a great deal of contact with family and other people? _____

Will your new dog live inside or outside your home? ___________________________________________

Will your dog be restricted from certain areas in the house or have full run of it? __________________________________________________________________________________________________________

Do you have a yard? _______

Is it a securely fenced in yard? _______ If not, are you willing to fence your yard to prevent the puppy from running off or being stolen? ________

Are you willing to provide pictures of your fenced yard and the living quarters that your new dog will be a part of? ________

Are you willing to give this dog the extra care that a Pug requires? (Specifically cleaning facial skin folds, eyes, and coat) __________

Are you committed to care for this dog’s needs for his/her lifetime? _______

Are you prepared for the cost of feeding, bathing, and the health care and maintenance of a dog? _______

What kind of relationship do you expect to have with the breeder after a puppy has been placed in your home? _____________________________________________________________________________

Are you willing to occasionally provide pictures of your pug puppy and details about him/her to the breeder? _______

Are you planning to spay or neuter your pug? _______ If not, why? _____________________________________________________________________________________________________________

Are you willing to accept a "Limited AKC Registration"? _______ (A limited registration is an AKC registration that registers your dog with the AKC but does not allow offspring of the dog to be registered.)

Do you own a pet carrier? _______ Is it clean? _______ Does the door close securely? ___________

If you don’t own a carrier will you purchase one prior to picking up the puppy? ________

How did you learn about our Pugs? _______________________________________________________

How much do you expect to pay for a quality, healthy Pug puppy with Champion Bloodlines and a Health Guarantee? (Our Pugs range from $1600 to $1900 depending on the conformation of the pup) __________

How do you plan on paying for your new Pug puppy? ________________________

Are you willing to sign a contract prior to purchase? ___________

Please list 3 references including name, address, e-mail, phone, relationship to you and years known.

 

 

 

 

 

 

 

 

 

 

Please use the area below for further information you wish to be considered in placing a Pug puppy with you. We would appreciate if you would give a little insight into the expectations you may have for this new addition to your family.

 

 

 

 

 

 

**Intentionally providing false information on this application will result in denial and loss of deposit. We reserve the right to verify all information provided, possibly including a visit to your home. By submitting this application you are certifying that all of your answers are true.

 

 

Thank you for your time and cooperation! Once we receive your questionnaire we will get back to you as soon as possible. We will be