APPLICATION FOR PRT FROM BLOSSOM VALLEY RANCH

Guardianship of another animal (you are one, too) is a major responsibility and a long-term commitment.  You may share 10-20 years of your life with the dog you purchase.  i have known Parson/Jacks to live to be 20-21 years old! 

In order for me to evaluate your suitability for one of my beloved dogs, you must be:  (1) at least 18 years of age; and (2) able and willing to spend the time and money necessary to provide the proper day-to-day care, training, and veterinary care for the dog for its entire natural life. 

Please answer the following questions and return to me by clicking on the Submit Button at the bottom of the form.

By typing my/our name(s) below and by submitting this application via this form, I/we agree that my/our typed name(s) constitute(s) an electronic signature for legal purposes, that the information provided in this application is true and correct to the best of my/our knowledge, and that any material misrepresentation in this application is grounds for the breeder to immediately rescind any Contract of Sale that results from it and repossess the dog with no reimbursement of price.

Your full name:

Your spouse/partner's full name:

Address:

City:

State & Zip:

How long at this address:

Home phone:

Applicant's work phone:

Applicant's cell phone:

Applicant's email address at home:

Applicant's email address at work:

Applicant's age:

Spouse/partner's work phone:

Spouse/partner's cell phone:

Spouse/partner's home email address (if different):

Spouse/partner's work email address:

Spouse/partner's age:

Names and ages of children:

Other People in Your House:  

Anyone Have Allergies to Dogs:  

Anyone Have Allergies to Dogs:  

Anyone Have Allergies to Dogs:    

PERSONAL INFORMATION