Application Form – Chosen Road Keep Pomeranians

Name *

First

Last

Email Address *

Address *

I'm interested in *

I'd like a *

Do you live in a *

Do you have a fenced yard? *

yes
no

Do you want a puppy for . . . *

Have you reviewed the Chosen Road Keep contracts? *

Please provide the name and contact information of your vet (or the vet you plan to use). You will need to contact the vet and let them know I will be calling to ask questions. *

Please provide the name and contact information of your groomer (or the groomer you plan to use). You will need to contact the goomer and let them know I will be calling to ask questions. *

If you rent or lease your home, please provide the name and contact information of your landlord. Please let your landlord know I will be calling to confirm you are allowed to have a dog in your home.

Tell me about yourself and your family, including the living situation and any other pets you have *

Please provide a little more detail about your preferences for a puppy. Include thoughts about color, size, temperament, etc.