EmailMe Form - Puppy Buyer Application Form

Which puppy are you interested in?

Name *

First Last

Address

Street Address City State / Province / Region Postal / Zip Code Country / Region

Home Phone

Mobile Phone

Email *

Web Site

Good time to reach you?

Family Data

Are you...

Your Age

Children?

Children's ages

Do you live in...

Do you have a secured fenced yard?

Black Russian Terrier Data

Are you interested in...

Gender interested in...

Why are you interested in obtaining one of Beautiful BRTS?

What qualities do you like in the BRT breed?

What don't you want to find in a BRT?

Is this your first BRT?

Previously owned dogs

Animals living at your home

Briefly explain why you have chosen this time to bring a new dog into the family & how all family members feel about it

Are you committed to caring for this dog for its life time?

Who will be the primary care giver for the puppy?

What percentage will your dog be in the following? House / Yard / Other

Have you ever house trained a puppy before?

Have you ever trained a dog before?

BRT requires regular grooming, who will be responsible for it?

Have you ever had to euthanize a dog?

Are you willing to spay/neuter this dog?

If you are considering breeding, do you promise to have this dog X-rayed for Dysplasia, finish it in conformation ring and title it in one of the working modalities as well as consult the breeder prior to breeding?

Do you have any special concerns about BRTs?

When and where did you learn about the BRT?

How did you hear about us?

Are you willing to keep us informed of your puppy's progress with regular updates and photos?

Signature (please type your name)

Date