Personal Name:

Street Address

City, State, Zip



About Puppy Residence:
Do You Have Children?


Dog's Primary Living Area
Do you have other pets (cats, dogs,etc.)
Uses for this dog:
Number of hours per day dog will be un-attended
Where will the dog stay when not at home
What gender do you want
What is your first color choice
What is your second color choice
Have you owned a dog before?
Have you used a crate to housebreak a dog before?
Are you willing to take this dog to obedience school?
Do you plan to spay or neuter this dog?
Why do you want a Labrador?
Former or current Veterinarian (reference)

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