Top Flight Golden Retrievers

Puppy Appplication :

Name:

Address:

Daytime Phone Number:

Evening Phone Number:

Cell Phone Number:

Number of Children:

0 1 2 3 4+

What are your childrens ages?

Other pets in the home:

Do your own your home?:

Yes No

How will this pup be housed:

Indoors Outdoors

Please describe how
your dog will be housed:

What is the primary
purpose of this puppy:

Companion Competition Hunter
Watchdog Therapy Dog Other

Have you participated
in an AKC sancioned
event? Please describe:

Sex Preferred:

Female Male No Preference

Will you accept a
pup of either sex:

Yes No

Color Preference:

Will this pup be neutered:

Yes No

Will this pup need to be shipped:

Yes No

What is the
nearest large airport:

Are you willing to provide references (Veterinarian, etc.) If requested:

Yes No

Your name can be put on a waiting list at any time and we will contact you when a breeding is planned. We require a $200 deposit to reserve a pup once the pregnancy has been confirmed. This deposit is non-refundable unless no puppy of the sex you wish is available from the litter.

Print This Form for your records PRIOR to clicking submit!

Thank You