*Name :

*Address:

*City/State/Zip:

*Home phone number: 

Work phone number: 

Other phone number: 

*E-mail address: 

How did you hear about Hatley Hollar Boxers? 

For what purposes are you purchasing a Boxer? Check all that apply. 
Family Pet
Obedience
Agility
Show
Hunting
Breeding
Other, please explain below:

Do you prefer (check all that apply):
Male
Female
No preference
Puppy, age preferred 
Adult, age preferred 

What is your color preference?
Plain fawn
Flashy fawn
Plain brindle
Flashy brindle
White
No preference

If your first preference regarding sex and color, isn't available, would you still be interested in a puppy?
No Yes

Do you prefer for your Boxer to have cropped or natural ears?
Cropped Natural

Do all family members want a new puppy?
No Yes

List the ages of all persons residing in your home: 

Is anyone in your family afraid of dogs?
No Yes

Is anyone in your family allergic to dogs? 
No Yes

Are you aware that Boxers are large dogs (65-85 lbs), and that they shed?
No Yes

Have you previously owned Boxers?
No Yes

Have you owned other dogs?
No Yes, please list what breeds, how many and when below:

Have you ever rescued a dog and helped place it for adoption or kept it yourself?
No Yes, please explain below:

Have you ever had a dog hit by a car?
No Yes, please explain below: 

Have you ever had to have a dog euthanized?
No Yes, please explain below: 

Have you ever shown a dog?
No Yes

Have you ever put an AKC title on a dog?
No Yes, please list name of dog/s and title/s: 

Do you own any other pets at this time?
No Yes, please list what kind and how many: 

Type of residence?
Single family home
Apartment
Townhouse
Other

Do you own or rent your place of residence?
Own Rent

Are you aware that a Boxer needs exercise? 
No Yes

Is your yard securely fenced? 
No Yes, please list what kind of fencing, height of fencing, fenced area deminsions, and type of locks on gates: 

Do you have a kennel run? 
No Yes, please give kennel run deminsions:

If you do not have a securely fenced yard or a kennel run, how do you plan to exercise your Boxer? 

If your dog will be left alone during the day, how many average hours a work day? 

Where will the dog be kept when you are not home?
Outside
Your bedroom
Child's room
Laundry room
Basement
Porch
Other 
Crated
Loose

If you are not at home during the day, what arrangements will be made to feed and exercise the puppy while you are not home?

Where will the dog be when you are home? 

Where will the dog be kept at night?
Outside
Your bedroom
Child's room
Laundry room
Basement
Porch
Other 
Crated
Loose

Who will be responsible for the dog's daily care, such as feeding, walking? 

What type or brand of food do you plan to feed your Boxer and how often? 

Who will be responsible for the dog's health care and veterinary visits? 

Do you have a regular veterinarian? 
No Yes, please list your veterinarian's name, address, and phone number:

Are you willing to take this boxer to obedience and puppy kindergarten classes in order that he/she will become an enjoyable companion and a good canine citizen?
No Yes, please list the training facility, address, and phone number:

Who will attend training classes with or otherwise train this Boxer? 

How would you describe your lifestyle as a family?

What type of recreation do you enjoy as a family?

How do you usually spend your family vacation?

How would your Boxer be cared for when you are on vacation?

If a divorce/separation should occur in your family, who would get custody of the dog? 

Are you aware that puppies require more time and attention than older dogs?
No Yes

Are you willing to make that kind of investment of your time?
No Yes

Are you willing to spay/neuter this dog?
No Yes

Are you aware that no matter how careful your breeder is, and even though your breeder obtains the appropriate clearances from the parents of the puppy, there is always a possibility that your puppy could inherit a genetic or congenital condition, including but not limited to heart problems, cancer, allergies, hip dysplasia, etc.?
No Yes

Are you willing to purchase a puppy knowing there is no such thing as a perfect puppy?
No Yes

After reading this questionnaire, do you still feel that you are willing and able to offer this type of commitment to a Boxer, so that the Boxer puppy you purchase will have the type of lifestyle that he/she requires and deserves?
No Yes

Are you committed to care for this Boxer’s needs for its lifetime?
No Yes

Would you agree to a home check?
No Yes

Why did you choose the Boxer breed and why do you think your family would be a good home for a Boxer?

Please list references of friends, breeders, or handlers that are familiar with you and how you care for your dogs or other animals.  Include name, phone number, e-mail address, and how long you have known the person:

Please supply additional comments and/or information below: