Your Name, address, phone number
Email Address:
How did you hear about us?
Which breed are you interested in? Boxer Rottweiler
What gender are you looking for? Male Female Either
Are you looking for Show or Pet Quality? Show Quality Pet Quality
Have you owned a...... Boxer Rottweiler
Do you have any kids? Yes No
Do you already have dogs? Yes No

If yes, what breeds and how old are they?

Where will the dog be kept during the the day? At night?
Do you have a fenced yard? yes no
Are you aware of the health concerns with this breed? Yes No
If you are wanting a show dog, have you shown before? Yes No
If we don't have puppies now, would you like to be put on our waiting list? Yes No

Please list any references or your veterinarian below
May we check your refrences and information given ? yes no
Here is your chance to tell us anything else about you, or what you think we should know about you.

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Thank you for your interest and taking the time to fill out the application!