Puppy Application

Thank you for taking the time to fill out our rather lengthy puppy application! Placing our puppies in responsible, quality homes that will care for and love them the way do it a TOP priority! If you’ve applied for a current breeding or litter you’ll hear from us shortly. If you have ANY questions do not hesitate to ask, our line is always open-
Welcome to the CHampagne Kennels Family
Nichole Rupert
941-306-7790

Name:*

First

Last

Address:*

Street AddressCityState / Province / RegionPostal / Zip CodeCountry

Phone:*

Area Code

Phone Number

E-mail:*

Do you own or rent your home?*

What kind of home do you live in?*

Is your yard fully fenced and secure?*

Yes

Do you have children? If yes: What are they're ages?*

Tell us about yourself and your family:*

Does anyone in your immediate family suffer from allergies to dogs?*

Do you have any health conditions/disability that may limit your ability to exercise your puppy/dog for up to 1 hour per day?*

Do you work full time?*

Have you ever owned a dog before? If yes; what breeds and how long ago?*

Do you own any other pets?ie another dog (list age, breed & sex)cats, rabbits, birds et*

Will your puppy sleep inside your home and be allowed inside the house with your family? *

Why is this your breed of interest?*

If you are applying for a puppy from a current or upcoming litter?If so please designate which;

Preferred sex:

Color or Marking Preference:*

Do you plan to breed your dog or keep him/her as a pet?*

Are you looking for a show dog?*

Yes

Tell us anything else you think may be important to us about yourself and your family*

Have You signed up on our waiting list?*

Yes