Lumberjack Bostons Puppy Questionaire

GeorgannKiera Mathis

Bakersville, NC 28705

828-260-6658
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This questionnaire is designed to aid us in the potential placing of a Boston Terrier into your home that will be compatible with your family and lifestyle. It may also help in areas where you may need information and guidance. If you would like to pursue the possibility of obtaining a Boston Terrier, please complete this form and return to us. In order to be considered for a Lumberjack Boston Terrier puppy you must:

(1) be 21 years of age
(2) have the knowledge and consent of all adults living in your household
(3) have a valid ID with current address
(4) understand that completing this application does not guarantee that you will get a puppy and Lumberjack Bostons must approve your application.

Name:

Address:

City, State & Zip code:

Phone number (s):

Email address:

What made you want to get a Boston Terrier? ______

How would you describe the area you live?

Apartment____ City____ Condo____ House____ Rural____ Suburb____

Are you renting or live in a Condo? Yes____ No____

If yes, does your landlord or “homeowners” allow dogs? Yes____ No____

Have you ever raised a puppy before? If yes, please explain.

______

Will your dog be an inside or outside dog?______

How many hours in a 24 hour time frame will your dog be left alone?______

Where will your dog stay when you are not home?______

Where will your dog sleep at night? ______

Do you have a specific request for who is the Sire/Dam of your puppy? ______

Are you interested in a:

Pet Male____Show/breeding Male_____
Pet Female____ Show/Breeding Female_____

If you would like a show/breeding puppy, please explain what your plans are for the puppy?______

Have you ever bred a litter of puppies? Yes____ No____

Do you understand that the wait for one of our Boston Terriers can be 6 months or longer? ______

What qualities are you looking for in a Boston Terrier?______

Have you ever owned a Boston Terrier? ______

Do you have a:

fenced yard____covered patio____shade trees____kennel or dog run____ or other (Please Explain)____

______

What brand of food do you plan on feeding your dog? ______

How would you potty train a puppy? ______

Do you plan on crate training? ______

How would you discipline or correct your dog? ______

How often do you plan on exercising your Boston Terrier? ______

Do you have any plans to move in the near future? ______If, at some time you do move, what will you do with your pet?______

Are you looking for a protection dog? Yes____ No____

What areas are you interested in for a dog? Companion___Therapy____ Conformation____ Breeding____Obedience____Agility____Tracking____Drafting____Search & Rescue____Other____

What energy level are you looking for in a Boston Terrier?

High____ A dog that fits in a very active lifestyle.A dog that likes to go where you go.

Moderate____ A dog that likes to go on regular walks, hikes & car rides. A dog that like to go where you go.

Low____ A dog that likes to go on walks and watch TV with you on your feet.A dog that likes a quieter lifestyle.

How many people live in your house?______

Do you have children? Yes____ No____ Their ages are?______

How do other members in your home feel about getting a Boston Terrier?______

______

Do you have other pets? Species, Breed, Age, etc.

______

Boston Terriers requireminimal amounts of grooming to maintain their short, beautiful coat. Are you willing to commit to keeping your dog groomed? Nails trimmed, brushing, bathing. This will also greatly decrease their shedding. ______

Are you aware of the potential health risks in a Boston Terrier? Please name a few.

______

Are you willing and able to maintain your dog’s routine expenses for its entire life? Yes____ No____

This would include things like food, vaccinations, Vet bills, training, boarding, toys, travel and many others.

Are you interested in keeping in contact with the breeder of your dog? Yes____ No____

Is your lifestyle the kind that will enable you to spend time every day with this beautiful,lively, intelligent dog? ______

Signed: ______Date: ____/____/____

Thank you for your interest in our Lumberjack Boston Terrier puppies! Please email back this application to You can also mail your application to

Lumberjack Bostons

640 Loggy Hollow Rd

Bakersville, NC 28705

We require a $300.00 deposit for our puppies. This is deducted from the purchase price. We want to make sure you have carefully thought through your decision to get a Boston puppy. Checks should be made out to Georgann Mathis or Kiera Mathis.

Thank you!

GeorgannKiera Mathis

Lumberjack Bostons