*Name:  

note: due to server security issues, if sending from yahoo or AOL email address; put yourname@oceanstateshilohs.com in the email section and note your correct email address
below in the comments section.

*Email Address:

*Primary Phone Number:   Other Phone Number:

Address:

City: State/Province:

Zip/Postal Code: Country: USA Canada

How did you hear about us?

1. What litter(s) are you interested in?

1st Choice Litter: 

2nd Choice Litter:

(We ask you to select two litters, in case we already have a realistic number of reservations on one.)

2.  Preferred Gender of Puppy:  No Preference Male Female

3. Preferred Coat Type:  No Preference Dual Sable

4. What are you looking for in a puppy?  Companion Only Conformation Showing Breeding Agility Obedience Therapy

5. Please tell us about the animals you share(d) your life with (names, breeds, etc.)

6. Do the dogs in your household get along with other dogs/puppies?

7.  How many people reside in your household? (number of adults; number of children and their ages)

8.  Does everyone like puppies and big dogs? 

9.  Please tell us about your home.  House Townhouse Apartment/Condo

10.  Do you own or rent?  Own Rent

11.  How long have you resided there? 

12.  Do you have a fenced yard?  Fenced Yard Invisible Fence Neither

13.  Do you work?  If so, how many hours will your puppy be alone during the day/night?

14.  Please provide your Veterinarian's Name, Address and Telephone Number. We intend to speak with your vet, in order to verify upkeep and care of your pet(s).

Any further questions and/or comments you may have can be included with this application. Please make your comments below:

Please contact us for further information and details regarding the deposit.

Once you have submitted your application, please email pictures of: Yourself and your family, Your pets, and Your home and yard to us at oceanstateshiloh@aol.com

Thank you for your interest in Ocean State Shilohs!