Puppy Application | NORTH STAR PEMBROKE WELSH CORGI'S

Name *

Email address *

Home address *

Phone Number *

Current Veterinarian Clinic *

Veterinarian Clinc phone *

Veterinarian Name *

3 References that are not family, please include phone numbers *

Why have you chose the Pembroke Welsh Corgi breed? *

Have you owned a Pembroke Welsh Corgi before? *

Yes
No

Where do you live? *

Rural
City

Type of yard? *

Fenced & private
Fenced, but shared
Wireless perimeter fence
No Fence, We live in apartment or townhouse.
No fence, but farm/ranch land.

If no fence, please specify how pet will be kept safe outdoors.

Do you own other animals? *

Cat
Dog
Bird/birds
Horse/horses
Cattle
Pig/pigs
Goat/goats
Other

If other please specify.

Total quantity of animals? *

Who will be primary care taker? *

How many hours a day will the dog be left alone? *

Where will the dog be left unattended? *

Indoor crate
Outdoor kennel run
In the house
In the yard
In the garage

Will puppy need to be shipped? *

Yes
No, I will pick my puppy up personally

If yes, please specify?

Do you plan on breeding? *

Yes
No

Will this dog be used for? *

Competition
Working
Pet

Do you prefer Male or Female? *

Which puppy are you most interested in? *

Additional Comments

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