Application to Acquire Parson Russell Terrier

APPLICATION TO ACQUIRE PARSON RUSSELL TERRIER

BLOSSOM VALLEY PARSON RUSSELL TERRIERS

PO Box 407

Aguanga, CA 92536

Guardianship of another animal is a major responsibility and a long-term commitment. You may share 10-20 years of your life with the Parson Russell Terrier ("PRT") that you acquire. For me to evaluate your suitability to have one of my beloved PRTs, you must complete the following questionnaire and return it to me at the email or physical address shown above.

HOW DID YOU LEARN ABOUT BLOSSOM VALLEY PARSON RUSSELL TERRIERS?

AKC Breeder Litter Advertisement

Breeders.Net Listing

 website from online search

Advertisement in ______

Personal referral from ______

AKC Conformation Dog Show contact with ______

Other: ______

PERSONAL INFORMATION:

Name______

Spouse/Partner:______

Address:______

City: ______State: ______Zip: ______

Home phone:______Work phone:______Cell phone______

Your age:______Spouse/Partner’s age______Children’s ages:__

How long have you lived at this address?______

May I visit your home to see the PRT and how you are taking care of it?______

What is your occupation?______

How long have you worked for your current employer:______

Home E-Mail: ______

Work E-Mail:______

Name, address, phone number of current employer: ______

______

______

______

How many hours are you away from home each day?______

What is your spouse/partner’s occupation?______

Spouse/Partner’s Home E-Mail: ______

Spouse/Partner’s Work E-Mail:______

Name, address, phone number of spouse/partner’s current employer: ______

______

______

______

How many hours are you away from home each day?______

Names, relationships, and ages of other people who reside in your home:______

______

Do all members of your household want to get a dog? No:□ Yes:□ If “no,” who doesn’t? ______

Do you □own or □rent your home? Is it a □house□apartment□condo? How long have you lived there?

DO YOU HAVE ANY OF THE FOLLOWING?

Fenced front yard? □No:□Yes: If 'yes," what size of yard and height of fencing?______

Fenced back yard? □No:□Yes: If 'yes," what size of yard and height of fencing?______

Pool? □No:□Yes: If “yes,” is it fenced?□No:□Yes: If 'yes," what size and height of fencing?

Screens on your windows?□No:□Yes: If “no,” can the PRT escape from open windows? □No: □Yes:

Screen doors?□No:□Yes:If "yes," do the doors have strong self-closing mechanisms? □No: □Yes:

YOUR AND YOUR SPOUSE/PARTNER’S EXPERIENCE WITH PRTS AND OTHER ANIMALS:

Have you owned or been around a PRT before? □No:□Yes:

If “yes,” explain:

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List any other dogs & animals that you and your spouse/partner have had in your lives and state what happened to them:

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PRTDESIRED?

When do you want to get a PRT? ______Sex desired: (i)Male:□ (ii) Female:□ (iii) No preference:□

Color desired: (i) White:□ (ii) White/black markings:□(iii)White/tan markings:□(iv)Tri-colored:□

Coat(s) acceptable: (i) Smooth:□(ii) Lightly broken:□ (iii) Heavily broken:□(iv) Rough:□

Age(s) acceptable: (i)Puppy (< 6 months):□; (ii) 6-12 months:□; (iii) 1 to 2 years old:□; (iv) adult (> 2 years):□

WHAT ACTIVITIES DO YOU PLAN TO DO WITH YOUR PRT?

Dog shows□; Agility□; Earthdog□; Barn hunt □; Dock diving□; Obedience□;Jogging □;Therapy dog□; TV/sleeping□

Will you take the PRT that you get to basic training classes?No: □ Yes:□

If "no," then why not?

______

______

MISCELLANEOUS:

Do You Agree To Spay/Neuter Your PRT and Send Me a Sterilization Certificate by 12 Months?

No:□ Yes:□ If “no,” why not?______

Who will take primary care of and responsibility for the PRT?

______

Where will your PRT stay during the day?

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Where will your PRT sleep at night?

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Under what circumstances would you surrender your PRT to a shelter or to me to rehome? ______

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If your puppy has an emergency or serious illness, what is the maximum you are willing or able to spend on veterinary care?

(i) None □ (ii) up to $100 □(iii) $101-250 □(iv) $251-500 □(v) $501-1,000 □(vi) $1,001-5,000 □ (vii) no limit □

REFERENCES:

Name, address, and phone number of your veterinarian reference:

______

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Names, addresses, and phone numbers of two personal references who can vouch for yourhumane treatment of animals and will know your whereabouts in the future:

Reference #1’s name:______

Address:______

Phone:______

Email address:______

Reference #2’s name:______

Address:______

Phone:______

Email address:______

AGREEMENT:

By typing or signing our name(s) below, I/we agree that:

• My/our typed name(s) constitute(s) an electronic signature for legal purposes if transmitted electronically,

• The facts provided in this application are true and correct to the best of my/our knowledge,

• I/we realize that all such facts are material to the Breeder's decision to sell me/us a PRT,

• Any such fact that is not true will constitute legal misrepresentation in the formation of any Contract of Sale ("Contract") that results from submission of this Application to Breeder,

• Such misrepresentation is grounds for the Breeder to immediately rescind any such Contract, and

• Such misrepresentation will give Breeder the right to repossess the dog that is the subject of any resulting Contract and retain all money paid for the dog, as liquidated damages, since damages for such misrepresentation are difficult to determine, prove, and calculate.

Applicant's Signature: ______

Spouse/Partner's Signature:______

Date signed: ______City/State where signed:______

Application Form for Parson Russell Terrier / - 1 - / Rev. 20150106