The following information is provided in consideration for a puppy from
Smiling Dalmatians
Name(s):
Street Address
City
State
Zip
Home Phone
Work
Cell
Your email address:
Please indicate your puppy preference:
Gender
Color
Is a patch acceptable?
Are blue eyes acceptable acceptable?
What activities are you planning for your Dalmatian? Conformation, performance, companion, breeding, etc. List all
that apply.
Are you willing to spay or neuter?
Please tell me about yourself
Have you eve been charged or conviceted of animal abuse or neglect?
If yes please explain:
Do you own/rent/lease your home
If you rent/lease, please provide your landlord's contact information
IDo you have children living in your home under the age of 18, either full time or part time?
Describe your yard (size, type and heighth of fence, shelter/structures, shade, etc.)
Have you ever owned a Dalmatian before?
If yes please tell me about him/her/them (ages-neutered. If deceased, when why and did you own at the time of death,
etc?)
If yes please tell me about him/her/them (ages-neutered. If
deceased, when why and did you own at the time of death,
etc?)
Have you owned any other breed?
.Please provide your Veterinarian's contact information
Have you ever surrendered a dog to a shelter or other organization? If yes please explain.
How much time do you have to spend with your Dalmatian?
Describe where your Dalmatian will be kept when you are away from home.
Describe where your Dalmatian will sleep.
Have you ever raised a puppy before?
Are you willing to attend training classes?
Does anyone who lives in or frequents your home have allergies?
Is anyone in your home concerned with white hairs on furniture, carpet, clothing, etc?
Consent/agreement
By submitting this form, I confirm that I am at least 18 years of age and that the above information is true and correct
to the best of my knowledge. I hold the breeder harmless in the event unfavorable information is discovered while
processing this application