First Name:
 

Last Name:
 

Age:
 

Address: 
 

City:  
 

State: 
   

Zip Code: 


Phone: 
  

Cell Phone: 
 

Email Address:
 

Do you own your home? 
Yes    No



Do you have a Veterinarian?
Yes    No

                 Name:
                

                 Address:
                
            
                 City:
                

                 Phone:
                

Do you have children in your household?
Yes    No

If you checked yes, what are their names and ages?


Are you willing to take your puppy to obedience class?
Yes    No


Do you have any other pets?
Yes    No


What are the breeds and ages?


Have you ever owned a Bernese Mt. Dog before?
Yes    No

Do you have a fenced yard?
Yes    No

What kind of fencing?


Do you have a preference in the sex of your puppy?
Male  Female  Doesn't Matter

Where will the puppy sleep?


Will the puppy have a crate?
Yes    No

How many hours per day will the puppy be on its own?



During this time where will the puppy be?


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