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* Denotes a required field
Personal Information
First Name*Last Name*
Address
Address2
CityStZip
Phone*Cell
Email*
General Information
Have you ever owned a dog beforeWhat Breeds
Do you currently own any dogsWhat Breeds
Are there any children in the homeWhat Ages
How Many
Are you considering breeding in the future
(does not decide sale)

Where will your dog spend most of his time
Will the dog run hunt tests?
Who will handle the dog?
Who will continue her training?

Tell me a little about your previous dogs (if any)
What is your experience with dogs (if any) ie, training, testing, breeding and hunting
Have you ever not been able to keep a puppy/dog before? Explain? Did you sell/give away/give back to breeder?
What is your objective for you new dog?

Please provide 3 references: one must be a Veterinarian
Animal occupations or HRC members preferred but not necessary
First Reference
Name
Occupation (if in animal field)
Phone
Email
How do you know?
Second Reference
Name
Occupation (if in animal field)
Phone
Email
How do you know?
Third Reference
Name
Occupation (if in animal field)
Phone
Email
How do you know?
 

***NOTE: Your form will be submitted even if you get an error page. We will receive all of your forms. Thank you for your patience.