Puppy Raising Application Form

Location of your home*

Type of housing*

Type of Home*

If "other" please specify

If you do not own your own home, do you have permission to have a puppy in the home?

If no, you must have permission in writing to have a puppy in your home before we can place a puppy with you.

YesNo

How many adults are in the house?*

Are there any children in the house?*

YesNo

(If Yes) How many children are there in the house?

Under 5

5 - 13+

Are there other dogs living in the house?*

YesNo

(If Yes) How many other dogs live in your home?

If you have dogs, please give details

Breed

Gender

Age

Is/are your dog(s) neutered? (Please note that this is a requirement)

YesNo

If you have a dog(s), do they regularly receive the following treatments:

FleaWormKennel CoughBooster Vaccine

Where do Your Other Dog(s) Live:

Will You Have Time Available Each Day to Socialize the Puppies Without Being Accompanied by Children or Pet Dogs?:

YesNo

Do You Work from Home?: (Please note having a flexible schedule is a Requirement):*

YesNo

If you do not work from home, are you willing to take the week off to mind the puppies?:

YesNo

Do you drive?*

YesNo

(If Yes) Do you have regular access to a car?

YesNo

(If Yes) Type of vehicle

If other please specify

Support Will be Conducted Virtually Through Phone And Video Calls. Are You Willing to Accept Support Virtually?:*

YesNo

Do you have good internet connection where you live?*

YesNo

Address Line 1*

Address Line 2

Town*

Post/Eir Code

County*

Date Of Birth*

By submitting this form, your information will be shared with us in line with our privacy policy

Home Socialising

We just need some more details

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