Midwestern Huskies » Puppy Application

Name*

Email*

Enter Email Confirm Email

Phone*

Address*

Street Address City State ZIP Code

How did you hear about us?*

What is the reason you are looking for a puppy?*

Click all that apply.

Are there children in the home?*

Ages of children?*

Click all that apply.

Who will this puppy be for?*

Who will be the primary caregiver of the puppy?*

When are you looking to adopt a puppy?*

Where will the puppy live?*

Do you rent or own?*

Written Permission from Owner*

Checking the box indicates that you have written permission from the owner of your residence to keep a Siberian Husky on the on premises.

How much time do you expect the puppy to spend alone in your house during any given day?*

Do you currently have any other pets?*

If you currently have a pet or pets please explain:*

(how many and what breeds)

Have you had pets in the past?*

If you had pets in the past?*

(how many and what breeds)

If you currently have pets, or had pets on the past, how long have you had them?*

Have you ever bred dogs in the past?*

Please provide a reference:*

Are you interested in a male or female?*

What type of puppy are you looking for?*

Questions/Comments?