EagleWing Kennels

Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Are you at least 18 years of age? *

YES

NO

Do you have permission to own a dog at your residence? *

YES

NO

Do all household adults approve of a new puppy? *

YES

NO

Have you or any household member ever been convicted of animal abuse or cruelty? *

YES

NO

Do you affirm you have the knowledge and means to properly care for a new dog? *

YES

NO

Have you read and agree to EagleWing Kennels Warranty and Terms of Sale? (top of application) *

YES

NO

Are you buying this puppy for yourself or someone else? *

SELF

SOMEONE ELSE

If someone else, does this person have permission to own a dog? *

YES

NO

N/A

Do you affirm that the information provided on this application is true and accurate to the best of your knowledge? *

YES

NO