Puppy Application

Your Full Name

Your Address

Your Email

Your City, State, Zip

Your Country

Your Phone

Why do you want a Black Russian Terrier?

How much exposure have you had to this breed?
To dogs of other breeds? Please indicate which breeds, under what conditions,
and how many.


Do you wish to obtain an adult or a puppy?
A puppyI prefer an adultI am willing to consider either one

For what purpose do you wish to own a Black Russian?

If you wish to own this adult/puppy for show/breeding purposes what
characteristics are most important to you?

If you wish to own a Black Russian for show/breeding, are you willing to
adhere to a show/breeding contract and co-ownership? If no what is the main reason?

If you wish to obtain a Black Russian as a companion, are you willing to sign a
limited registration contract and/or a spay/neuter contract?
YesNo

If you wish to obtain a Black Russian as a companion, but may be willing to let
us show it, are you interested in learning more about providing a co-ownership
home for members of our breeding stock?
YesNo

Are you interested in a Black Russian of a particular gender? Please explain.

Do you own or rent your home? If you rent, can you
provide a statement or pet deposit receipt from your landlord granting you permission to
keep a Black Russian on their property?

Do you have a fenced yard? If not, what are your plans for exercising your
Black Russian and keeping him/her contained?

What kind of flooring and/or surfaces will your puppy be raised on? Will
your puppy/dog reside in the house with the family?

Do you plan to take your Black Russian to obedience classes?
Yes, I consider it importantIʼm not sureNo

Are you capable of meeting the social, physical, and training needs of this
Black Russian?
Yes, definitelyIʼm not sure, whatʼs involved?I have some doubts

Do you have children?
What are their ages?
Have they been exposed to large dogs in the past?
Were there ever any problems with your children and dogs?

Do you have other dogs?
If so, how many, what breeds, and are they intact or altered?

Are there any family members at home full time?
If not, what arrangements do you plan to implement for your Black Russian in
your absence? How much time do you have available to spend with your Black Russian?


Have you met any Black Russian Terriers in the past? What were your
impressions of the breed?
YesNo

Can you meet the needs of a Black Russian financially?
Yes, definitelyIʼm not sure, whatʼs involved?I have some doubts

Do you agree to provide a safe, healthy, structured home environment for
your Black Russian? Please explain what makes you feel you are a good
candidate for one of our puppies?
YesIʼll tryThatʼs none of your business

References Please provide name and contact information for your veterinarian
(if you already have one) and provide at least one other reference who is aware
of the environment in which your Black Russian will be kept.