Periwinkle Pugs
Application
Please complete each section of this form to the best of your ability.
Today's Date:
Your name:
Your street address:
Your city, state, country & zip:
Email:
Phone:
Occupation:
How did you hear about us?:
How did you choose this breed?:
Do you currently have any other
pets? If so, please list each pet:
Have you ever owned
dog(s) before? if so, what
happened to each of them:
Please describe where you
live, and how the Pug will live:
Do you OWN or RENT your home?:
Your preferences, please check ALL that apply:
Puppy Young Adult Older Pug Any age Male Female Either Black Fawn Either
Expectations you have for your Pug, please check ALL that apply:
Showing/Conformation Agility Obedience Therapy Dog Breeding Family Pet Only Not Sure
Any questions, comments, or feedback you would like to add:
