Bluestone Kennel English Cocker Spaniel

Puppy Application Form

In order to ensure our puppies will be going to loving homes we kindly ask that you
complete all of the following questions listed below. Please feel free to add any additional
comments. This information is important to us in order that we may be able to best match
puppies to each individual home.
Your Full Name________________________________________________________
Address_______________________________________________________________
City ________________________________ Province ________________________
Postal Code ____________________________ Country _______________________
Phone Number ________________________ Email ___________________________
1.

How were you referred to us?

__Breed Club or Other Breeder

__Friend

__Internet Search

1. Do you own your home, rent or live with others?

__Home Owner
__Rent __Live with others
If you rent, does your landlord agree in writing to allow you to have a dog on the?
__Yes
__No
2. How long have you lived at your present address? ________
3. How many people do you currently reside with?_____________
Are there any children living with you? __Yes
__No
4. Does every member in the family wish to adopt a new puppy? __Yes __No
5. Who will be the puppy/dog's primary caregiver? __________________________
6. Is there someone home during the day? __Yes

__No

7. How many hours would the puppy/dog be left at home, alone, unattended during the
day? _______________
8. Where will the puppy live, ie spend the majority of its time? _______________

9. Does your home have a securely fenced in yard and if not, are you willing to build
one?
__Yes
__No, not willing to build one.
__No, willing to build one.
10. If you are unwilling or able to erect a fence, how do you plan to prevent your dog
from roaming or being stolen?
_______________________________________________________________
11. Do you have a pool? __Yes

__No

If yes, is it fenced? __ Yes __ No

12. Does anyone in your household have allergies to pet hair or dander? __Yes __No
13. Is anyone in your household afraid of dogs or does anyone dislike dogs?
__Yes __ No
14. Have you ever owned an English Cocker Spaniel before? __Yes
__No
If yes, who did you obtain it from?______________________________________
15. Have you ever owned another breed or type of pet? __Yes
___No
If yes, please specify what type(s) and what happened to them (i.e. how long did they
live; how did they die)? ___________________________________________________
_______________________________________________________________________
16. Are there any other pets (dog, cat, other) residing with you right now? __Yes __No
If yes, please specify what species, breed, age and gender of each pet.
____________________________________________________________________
17. Do you plan to have your pet/companion English Cocker Spaniel spayed or
neutered? __Yes __ No
18. Do you plan to attend, at minimum, one set of obedience classes with your puppy?
__Yes __No
19. Do you plan on using a crate for your puppy? __Yes

__No

20. Do you have a regular veterinarian? __ Yes __ No

May we contact them for a reference? __Yes
__No
If yes, please provide the clinic name, veterinarian name and a phone number.
Clinic Name: ______________________________________________________
Veterinarian Name: _________________________________________________
Phone Number: ____________________________________________________
21. Please provide the name, email, phone number and relationship of at least two
references.
Name: __________________________________________________
Email: __________________________________________________
Phone Number: ___________________________________________

Relations:________________________________________________
Name: __________________________________________________
Email: __________________________________________________
Phone Number: ___________________________________________
Relations:________________________________________________
Tell Us What You Would Like:
1. What characteristics are you looking for in your English Cocker Spaniel (i.e. size;
colour; activity level)?______________________________________________
________________________________________________________________
________________________________________________________________
2. What gender are you primarily interested in? __Male

__Female

3. What color would you like? ___ Blue Roan ____Orange

4. For what purpose are you adopting this puppy? ___ Pet Therapy ___ Family Pet
___ Obedience / Rally / Agility ___Conformation Show ___ Breeding
___Hunting ___Other
Thank you for completely the Bluestone Puppy Application. Please return completed
application to us at your convenience. Feel free to call or email us with any questions or
comments.
THANK YOU