First Name:
Last Name:
Address:
City:
State:
Zip Code:
Phone Number:
Have You Ever Had A Dog?	Yes No
Do You Have Any Dogs Now?	Yes No
What Methods Will You Use To Housebreak And Obedience Train Your Dogs?
How Much Time Do You Have Available To Devote To A TGOS Puppy?
How Much Time Will The Puppy Spend Unattended Each Day?	Please Select 1 Hour 2 Hours 3 Hours 4 Hours 5 Hours 6 Hours 7 Hours 8 Hours 9 Hours 10 Hours 11 Hours 12 Hours More Than 12 Hours
What Is The Name Of Your Veterinarian?
What Is Your Veterinarians Phone Number?
Do You Have Any Other Types Of Pet In Your Home Now?	Yes No
Do You Have A Fenced In Yard?	Yes No
Please List The Names And Ages Of Any Other Family Members Living In Your Home:
Please Tell Us Why You Would Like To Raise A Puppy For Our Program:
Email Address:
Additional Comments: