ASunRay Havanese Puppy Application
Name *
Prefix
First *
Last *
Suffix
Home Address *
City *
State and Zip *
Telephone number *
Email *
Confirm *
Today's Date *	MM / DD / YYYY
Why did you choose the Havanese breed?
What is your gender preference?	male   female   no preference
Do you plan to breed? *	yes   no   maybe
When are you wanting your Havanese?
Do you have other pets? Please describe.
If you have children, what are their ages.
Who will be the primary caregiver of your puppy?
Where will your puppy live and exercise? *
How many hours a day will your Havanese be home alone? *
Please check your activity goals for your puppy.	Pet Companion    Therapy   Obedience   Conformation   Agility   Rally   Other
Do you have a fenced yard? *	yes   no
Would you be willing to consider an older puppy or adult?	yes   no   maybe
Name and contact information for your vet
Information of two personal references
How did you hear about Asunray Havanese?

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