Puppy Application

If you’re interested in giving one of our Jacks a forever home, please fill out this application. We’ll be in touch with you as soon as we can.

Name
Street Address
City
State
Zip
Email
Phone
When's the best time to call?
What's your occupation?
In what type of dwelling do you live?
Please list the number of adults and children living with you, and their ages.
If you rent your home, do you have your landlord's permission to keep a dog?
What gender of dog would you prefer?
What age dog would you prefer?
How long have you lived at your current address?
Do you have a fenced yard suitable for a dog?
Do you own a dog crate?
Where will the dog sleep?
Where will this dog be primarily kept?
How many hours a day will the dog be left alone?
Please list the breeds and ages of other dogs or large animals that you currently own. Also, are these dogs spayed or neutered?
Have you ever owned a Jack Russell Terrier before?
What activities do you plan to do with this dog?
Do you have a current veterinarian? If yes, please provide their name and contact information so we may forward any medical records.
Do you have any questions or comments?
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