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City, Province/State:            

Zip/Postal Code:                  Email:

Phone Number:                 Home         Other

Emergency name and number:     

1.   Describe your family composition (adults/children, ages, other pets)

2.   Describe why you would like a Coton de Tulear and when you are looking to add a puppy to your family

3.   Are all members of the family in agreement on getting a Coton de Tulear?       

4.  Are you looking for a male or female?        Why?

5.   Describe what information you have about Coton de Tulears:

6.   Are you familiar with the care required?  Grooming?  Feeding?    Exercise? 

7.   Is someone home through the day?            If not, what arrangements have been made for the comfort and wellbeing of the puppy?

8.   How do you intend to train your Coton de Tulear?

9.      Do you have a fenced yard?       Yes     No 

10.   Do you have a pool?                    Yes     No          Is it fenced?   Yes     No 

11. Have you ever euthanized an animal?     Yes     No              Why?  please explain ...

12. Have you ever had an animal injured?    Yes     No               Please provide details ...

13. Do you have a veterinarian?  Yes     No         Please provide his name and phone number:

14. Do you have a trainer?  Yes     No                  Please provide his name and phone number:

15. Have you ever bred dogs?  Yes     No          When?  Why?            Please provide details ...

Have you ever put any championship or working titles on any dogs?  Please provide details.

16. Coton puppies are typically over $2,000.00 and reservations require a non-refundable deposit of $500.00.  Additionally there are costs for additional vaccinations, other veterinary care, grooming, feeding, toys and accessories, and training.  Are you financially able and willing to afford and commit to the costs of a new puppy with respect to the costs involved in ensuring the comfort, happiness, and wellbeing of the dog?

                                         Yes     No   

17. Are you willing to follow the advice of your breeder with respect to care, feeding, and grooming of your Coton de Tulear?

                                         Yes     No 

18. Do you have any references we may contact to determine your suitability for a puppy?