Name:
Address:  
City:
State: Zip Code:
Phone Number Home:
Phone Number Work:
Email Address:
Most convenient time to reach you:
How were you referred to me?


Marital Status: Married Single Divorced Widowed Widower

Do you have children? Yes  No
Boy(s) or Girl(s)
Ages?


Your age and spouse if applicable?

Occupation of adult(s) in family?


Others in household who will have contact with the puppy?


Where will the puppy sleep during the day?
Where will the puppy sleep during the night?

Please describe the facilities you have for adequate protection and housing if the puppy is outside for periods of time, i.e. describe type of fence or run?


Do you live in: Urban Suburban Rural
Do you own or rent home or apartment?

Are you interested in: Male Female No Preference

What color are you interested in? 
Black  Yellow  Chocolate  No Preference

Why have you chosen this particular color?


Why are you interested in obtaining one of my Labrador puppies?
Companion  Show  Obedience  Therapy/Service
Agility  Hunting  Breeding  Drug Detection  Seizure Alert

Have you ever been active in competition/obedience with a dog?
Yes or No
If so, what type of competition/obedience?

Please list titles, certificates, or accomplishments with your dog:


Are you willing to participate in Puppy Basic Obedience Training as a condition of adopting a McNeil puppy?
Yes or No

Is someone at home or able to come home for house and crate training during the day?
Yes or No

Do you belong to a Kennel Club? Yes or No
If so, please list the Kennel Club, location, and two personal references:


Please provide additional information about your interest:


What qualities do you like about the Labrador Retriever?

What don't you want in a Labrador Retriever?


Is this your first Labrador Retriever? Yes No

Previously owned dogs:
What Breed (s)?
What Sex?

Have you or your neighbors had Parvo Virus at your home/neighborhood during the past three years? 
Yes No

Have you ever euthanized (put to sleep) a dog? Yes No
For what reason?

If your dog died, what from, and at what age?


Please list animals that you have at home now:


Name, address, and phone number of your Veterinarian:


Are you committed to caring for this puppy for its lifetime?
Yes No

Are you willing to spay/neuter this dog? Yes No
If not, why?
If you consider breeding, you must have hips and elbows certified at two years of age, and eyes must be examined and certified annually. Proof of certifications must be provided to me prior to breeding. Do you object to this? 
Yes No

Have you read my Breeding Philosophy page at this website?

 Yes No 
 

List some of the books you have read on dogs, specifically the Labrador Retriever:


Please tell me about the expectations you have for this new addition to your family:


Are you willing to come in person to pick up your puppy?


Additional Comments:


Deposits are not valid unless you have completed an Adoption Application and read and signed the Juvenile Dog Purchase Agreement and Health Guidelines.  I will send these documents to you once you are approved for adoption.