Name *

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Do you have any children in your home? *

Yes

No

Are all members of your household away during the day? *

Yes

No

Do any members of your household have a disability that you may want to train the dog for? *

Yes

No

Do you own a swimming pool? *

Yes

No

Do you own your home or rent? *

Own

Rent

Do you currently own any other pets or livestock? *

Yes, I own other pets or livestock

No, I do not currently own any animals

Do you agree that if at any time you are unable to keep your puppy/dog (for whatever reason) that you will contact Michael Cooper at Michael Creek Goldens for assistance in placing him/her in a manner that best suits their needs? *

Yes

No

Do you have a fenced yard or fenced exercise play area for your dog? *

Yes

No

Do you understand that we will not allow a puppy obtained from Michael Creek Goldens to be tied or chained in any manner? *

Yes

No

Do you understand that Goldens thrive on human attention and cannot be isolated from the rest of the family? *

Yes

No

Do you understand that a puppy purchased from us must be a part of the family and not a dog that lives outdoors all of the time? *

Yes

No

Do you plan on using a crate to help house-train your puppy? *

Yes

No

Have you ever taken canine obedience training courses? *

Yes

No

Do you plan to take canine obedience training courses with this puppy? *

Yes

No

Are you prepared to feed a premium dog food to your dog? *

Yes

No

Do you understand your dog must be neutered/spayed? *

Yes

No

Do you understand that we sell all of our puppies on a non-breeding contract and it may not be bred unless this contract is removed by mutual consent? *

Yes

No

Do you understand that if you decide to purchase a puppy from Michael Creek Goldens, we do require a $500 deposit to reserve a puppy for you, which will be deducted from your purchase price? *

Yes

No

Will you allow a home visit by the breeder or breeder’s representative (if too far away) before a puppy is placed in your home? *

Yes

No

By checking the box below, you agree to all the conditions listed above and state that the information you have provided is accurate and true. *

I agree