Application – BRICK CHAPEL SHILOHS

Applicant Information

Name

First

Last

Email

Phone

address

How did you hear about us?

Getting To Know You

about you

adults only

adults + small children

adult + grown children

(check all that currently apply in your home)

other pets

currently own a Shiloh Shepherd

owned a Shiloh Shepherd previously

this is my first dog

owned dogs previously, but none at the present

dog(s) are currently in the house

cat(s) are currently in the house

dog(s) & cat(s) are currently in the house

other type pets are currently in the house

(check all that currently apply in your home)

about your home

(check all that currently apply)

Puppy Specifics

the puppy

(check all that apply)

Puppy's Life

health care & licensing

veterinarian wellness visit at least once per year

keep puppy up-to-date on all vaccines

screen for heartworm & use heartworm preventative

use flea preventative

keep puppy properly identified (tags/microchip)

abide by all state and local laws concerning dog ownership

(check all that apply)

veterinarian's name and contact info

Breeder Relationship

agree to return Shiloh to Brick Chapel Shilohs should you be unable to keep it

agree to provide regular follow up reports on the health & well being of your puppy

(check all that apply)

formal training, etc.

(check all that apply)

puppy's daily life

puppy will be crate trained

puppy will spend most of time in the house

puppy will spend most of time in a fenced yard

puppy will spend most of time in a kennel run

puppy will spend most of time on a leash/chained

puppy will spend most of time loose outside

puppy will be left alone less than 4 hours per day

puppy will be left alone between 4 - 8 hours per day

puppy will be left alone for more than 8 hours per day

(check all that apply)

More Details

References

Additional Comments

Submission...
By submitting this application, you agree to authorize the veterinarian listed above to release information to Brick Chapel Shilohs. Should your application be accepted, a DEPOSIT will be required. Thank you for your interest in Brick Chapel Shilohs!