Application Questionnaire

This application questionnaire is designed to get all of the necessary information we require from applicants before considering them as a candidate for one of our sweet Cotons. Just a note; this application form is comprehensive and requires quite a bit of info for you to have on hand. Feel free to browse the form to see what it requires before filling it out. However, this application does autosave! (as long as you don’t clear your cache/history) so if you exit while filling out the application, the form will save your progress, and you can return and keep filling the form from where you left off!

Applicant Information

Applicant’s full legal name

Email address

Phone Number

Best time to call

Occupation

Physical address, city, and province

Mailing address, city, and province (if different than your physical address)

How did you hear about Crackerjack Cotons?

Household Information

How many occupants live in your household? Please include ages and occupations for all individuals

Do any individuals in your household suffer from allergies? What kind?

Do you own any other dogs/pets? (Please provide a list including breed/mix, age, altered/intact)

If you currently have no pets, please tell us what previous experience you have had raising a puppy/dog

Housing type? (House/Apt/Condo/Trailer/etc.)

Do you rent or own?

If you rent, have you approved a puppy/dog with your landlord?

Landlord’s name and phone # for verification

Are you willing to furnish photos upon request of your home to show the indoor and outdoor living conditions of your puppy/dog?

Do you have a fenced yard?

If not, what accommodations will you make to ensure your puppy/dog will get adequate exercise?

Have the primary/adult members of the household agreed upon getting a puppy/dog?

Is this puppy/dog meant as a surprise or a gift?

Have you or anyone in your household bred any sort of animals before? If so, what kind & how long ago?

Have you or anyone in your household ever returned a pet for any reason (to a breeder or a shelter)? If so, explain

  How many hours a day are you home or do you have to devote to your dog?

Describe the activity level of your household.

Based on these activities, how do you anticipate your puppy/dog will participate?

Describe your travel habits (frequency/duration/distance/mode)

Will your puppy/dog be accompanying you?

If not, what arrangements will you plan for its care in your absence?

Well-Being Information

Do you currently have a veterinarian? If so, please provide contact information (name of clinic, preferred
veterinarian, phone #)

If you do not currently have a veterinarian, have you started looking for one in your area?

What is your understanding of the medical requirements your puppy/dog will need?

What vaccination protocol do you plan to follow/does your vet follow?

What is your control plan for fleas, ticks, and other parasites?

  Who will primarily be responsible for your puppy/dog?

Have you ever raised a puppy before? If so, what breed/mix?

What understanding do you have about requirements for training the basics to a puppy, such as potty
training and obedience?

  Do you plan to crate/kennel your puppy?

Do you plan to do your training by yourself or attend classes? What are your preferred training methods?

What sort of diet do you plan to feed your puppy/dog (kibble/raw/etc.)? If you have a preferred brand, what is it

Coton de Tulears require a considerable amount of grooming compared to other breeds. Describe your
plans to keep your puppy/dog in good health through grooming.

The proper placement of our puppies and dogs is paramount. Purchasers must agree to stay in touch with us and be willing to supply pictures of this puppy/dog via e-mail or other electronic means on a regular basis. This is for the purpose of providing us peace of mind that our puppy/dog has been placed in a loving/safe home. Are you willing to comply?
yesno

Coton de Tulear Information

What attracted you to the Coton breed?

  Have you met a Coton before?

If you have never owned a Coton de Tulear before, what research have you completed to ensure this is
the breed for you?

  In your own words, describe what Cotons are like (temperament/behaviour)

Are you looking for a young puppy, an older puppy, or an adult?

Are you looking for a pet, a show dog, a performance dog, and/or a breeding dog? (List all that apply.)

What are your expectations from the puppy/dog (general temperament, goals you’d like to achieve, etc.)?

Would you prefer a male or a female?

If the opposite sex becomes available, would you be interested?

Are you willing to go on a waiting list for a puppy/dog? If so, how long would you be willing to wait until one becomes available?

All pet contracts include a spay/neuter clause. Are you willing to have this puppy/dog altered if purchasing as a pet?

If purchasing on a breeding contract, are you wanting full or limited rights?

Do you have any questions for us?

Please provide three references of various affiliation (breeder, friend, family member, puppy buyer if you
breed, in the following format: Name, affiliation, years known, phone number).
Reference One

Reference Two

Reference Three

Do you understand that if, at any time in the dog’s life, you can no longer keep/care for him/her you must contact us immediately? (Unless otherwise discussed, ALL Crackerjack puppies/dogs MUST come back to us as breeders.)
yesno

I, (print name) have filled out the above questionnaire
truthfully and to the best of my ability. I understand that the breeder, Crackerjack Cotons, asks these
questions to help select the best possible puppy/dog buyers and to help match potential buyers to litters/
puppies that will best suit their needs. Crackerjack Cotons may approve or deny this application at their
own discretion. I give permission to Crackerjack Cotons to contact my veterinarian, landlord, and
references.

Date

Applicant's Signature (Draw Below)