If you are interested in being considered for a puppy, please fill out the following questionnaire. The purpose of this questionnaire is to help me decide if a Pug is a good fit for your living situation. As a breeder, my responsibility is first and foremost to my puppies.

Your contact details and residential address
Name: Street:
Email: Street:
Phone: ( ) City: State:
ZIP:  
Your pug and other dog experience
Have you ever owned a pug? Yes No
What made you decide to purchase a pug?
 
Do you prefer a male or a female? Male Female
Why?
 
Which color do you prefer? Fawn Black No Preference
Which of the following activities are of interest to you? (check all that apply)
Conformation Obedience Agility Family Pet Other:
Have you ever earned a title on a dog? Yes No
If Yes, please list what type:
Are you planning on attending training classes? Yes No
If not planning on breeding or showing, would you be willing to have your pug spayed or neutered? Yes No
Do you currently own any other dogs? Yes No
If Yes, please list them along with breed, age, gender and spay/neuter (desexed) status:
Breed:     Age: Gender: M F      Desexed? Yes No
Breed:     Age: Gender: M F      Desexed? Yes No
Breed:     Age: Gender: M F      Desexed? Yes No
Breed:     Age: Gender: M F      Desexed? Yes No
Breed:     Age: Gender: M F      Desexed? Yes No
If you currently do not own any dogs, can you tell me about your past experience with dogs and pugs specifically?
 
Have you ever given a dog up to a shelter, pound or rescue group? Yes No
If Yes, please explain:
 
Have you ever returned a dog to its breeder? Yes No
If Yes, please explain:
 
Your environment
Do you have young children? Yes No
If Yes, please list their names and ages below and give me a brief idea of their exposure to dogs:
Name: Age:
Experience:
Name: Age:
Experience:
Name: Age:
Experience:
Name: Age:
Experience:
Is your yard fenced? Yes No Partially
If not, what are your plans for exercising your dog?
 
Does anyone in your family have allergies to dogs? No Yes Don't know
Who will be the primary care giver?
How many hours per day will this dog be left alone? None 1-3 3-6 6-9
Where will the dog be when no one is home?
Where will the dog sleep at night?
About that puppy...
Are you willing to stay in regular contact with us for the life of the dog and provide updates? Yes No
How much do you expect to pay for a puppy?
How do you plan for the puppy to get to you i.e. pick up, ship?
Have you spoken with any other breeders? Yes No
If Yes, please list them:  
Breeder 1: Breeder 2:
Breeder 3: Breeder 4:
Have they added you to their waiting list? Yes No
How did you learn about my pugs?
 
Are you interested in being contacted about an older dog needing placement? Yes No
References
Please list several (at least 3) references. Preferrably a veterinarian, a person active in dogs or a close acquaintance.
Name: Phone: ( )
Relationship: Email:
Name: Phone: ( )
Relationship: Email:
Name: Phone: ( )
Relationship: Email:
Name: Phone: ( )
Relationship: Email:
         
Thanks for taking the time to fill out the questionnaire. We don't have litters that often - perhaps once or twice a year.