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First Name
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Last Name
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Address
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Physical address, NO P.O. Box's
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City
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State
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Zip
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E-Mail Address
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Mobile Phone
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Land Line
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Phone Number
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Mobile Phone
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Land Line
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Phone Number
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We need a copy of your mortgage statement or tax bill
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Own
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Housing, Do you
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We need a letter from the landlord or a copy of your lease
stating that pets are allowed
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Rent
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Will this be your first Chihuahua?
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Yes
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No
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If NO, please tell us how many you have/had and their age and sex
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Do you own any other animals, other than Chihuahuas?
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No
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Yes
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If Yes, Please tell us how many, what breed, and their ages
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No
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Have you researched the breed?
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Yes
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Do you currently have a Veterinarian?
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Yes
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No
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If Yes, the Veterinarian's Name & Number
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How many hours a day will
the puppy be left alone?
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How many hours a
day will the puppy
be crated?
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Childreen's ages if under 18
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How many humans live in the home?
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Is everyone in the home in
agreement with getting a new puppy
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Yes
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No
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Do you have a specific puppy in mind?
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Yes
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No
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If yes, Which puppy?
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Do you have a preference as to the sex of the puppy?
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No Preferance
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I prefer
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Male
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Female
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Do you have a color Preference?
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Do you have any issue with the required spay / neuter contract?
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No
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Yes
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If YES, please explain why
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We offer discounts for Senior Citizens, Military and for Repeat clients,
Do you fall into one of those categories?
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No
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Yes
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This application is just that, an application. It does not constitute a sale or hold
of a puppy. No puppy will be placed on hold until this application is approved
by the breeders Becky and Don D’Allaird. The placement of our puppies is the
most important part of our business. Our goal is to ensure that each of our
families are completely educated on the commitment and responsibility that a
new Chihuahua puppy requires and have the resources required to care for a
new puppy. I understand that by signing this application it does not guarantee
me the purchase of a puppy or to be placed on a waiting list. I also understand
that the breeders Becky and/or Don D’Allaird have the final say as to whether to
approve or deny the application.
The breeders Becky and/or Don D’Allaird will notify you within 96 hours of
receiving this application as to its approval status.
If you do NOT hear from us within 96 hours please email us at
Becky@BellasLittleAngels.com
Please type your name below
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By typing your name here you
agree that it is accepted as your
true signature
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By submitting this form you agree that you
answered all the questions truthfully to the best of
your knowledge. Any false information entered can
cause this form to be void and any deposit placed on
a puppy to be forfeited.
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