Book A Puppy Fields marked with an * are required Name * Address * Province * Email * Website Phone * Date of Birth * Marital Status * Names, Ages and Occupation Of Household Members * Does Anyone In Your Family Have Allergies To Dogs? * Yes No Please list other pets at hone. Are they all fixed? * Yes No Which vaccination tests have your pets had? * Vet name and phone number * Please list any previous pets you have had in the last 5 years and what happened to them. * Have you surrendered any animals to a shelter and if so, why? * Will this pet be allowed to be an indoor pet with outdoor supervision? Explain. * How many hours will they be alone each day? * Are You Going To Sterilize? * Divider HTML I would like to adopt: Gender * Male Female No Preference Age * Adult Puppy Coat * Blenheim Black & Tan Tri Colour Ruby Divider Do you have a name in mind for your puppy? If you rent please provide your landlords contact details . * Are you planning to move soon? * Yes No Please list anything you would like to include regarding your experience with animals. * Please provide 2 references telephone and email contact details as well as relationship to you. * If You Are A Breeder Please Provide More Information About Yourself And Your Kennel: HTML I understand that making false statements on this application or allowing the animal to be outdoors unsupervised for any significant time, could potentially lead to cancellation of any contractual agreements with BronArnies Kennel, or null and void any health guarantee. I understand that in the event that a puppy becomes unavailable for some unforeseen reason, the deposit will be transferred to another puppy of same sex and quality for the same purpose specified. However, if I back out for any reason my deposit will not be returned. I Accept I Do Not Accept Recaptcha If you are a human seeing this field, please leave it empty.