GOLDENDOODLE WORLD CANINE APPLICATION FORM

FIRST/LAST NAME:____________________________________________________________________

MAILING ADDRESS: ___________________________________________________________________

CITY/STATE/ZIP CODE: ________________________________________________

PHONE NUMBER & AREA CODE: ___________________________

GENDER PREFERENCE: First choice _________ Second Choice: _________NO PREFERENCE:_________

* If you have a specific gender preference, please only select one choice. If you do not have a gender preference, please check "no preference" and we will match you accordingly. Gender can not be guaranteed until we have your deposit/payment and we have assigned an available pet to you. This application and payment in full if the canine is ready to go or a deposit of half the total cost if the canine is not ready to go, is required to be in your file, signed by you, the buyer, prior to personal pick up, personal delivery or shipment.

COAT COLOR PREFERENCE: (NONE) __________(FIRST CHOICE)______________

(SECOND CHOICE):_________________ (THIRD CHOICE): _____________

*We will match you as closely as possible to your personal preferences. If you only have 1 choice, please leave the other fields blank. Please call ahead of time to ensure we have the color or coat type you desire.

What coat style are you seeking for your pet? SHAGGY:________ CURLY: ________ SMOOTH:_______ Unknown: ________

*Please call ahead of time so that we can tell you what coat type we have available, if you have a particular preference.

Pets come in a variety of eye color such as brown, amber, blue or green. What color eyes are you seeking

with your puppy? : __________________

* Eye color other than brown are only available at random. Please call ahead of time to ensure we have the eye color you desire.

Pets come in a variety of sizes. What approx. size are you seeking?: __________________

* We do not guarantee exact heights, lengths or weights on any purchased pet regardless of breed unless the canine is an adult and has been weighed by our vet. We will, however, match you as closely as possible to the size you are seeking to purchase if the canine is a puppy.*

WHAT BREED OF PET ARE YOU REQUESTING? :_____________________

*Please call ahead of time to ensure availability. 704-278-DOGS (3647)

WHAT AGE OF PET ARE YOU SEEKING? _____________________

*Please be aware that pets age by the day and we are not always able to update our website on a daily basis. We do not, under any circumstances, guarantee advertised pets to be an exact age unless their birthdate is notated on our web site. If you require a pet to be an exact age then you must call us before submitting this application to ensure the date of birth of a pet you are interested in.

ARE YOU REQUESTING A PET FROM A SPECIFIC LITTER? IF SO, WHICH ONE? __________________

_________________________________ *Please be aware that we can NOT guarantee any specific litter unless the pet has been specifically assigned to the buyer through our application process. We require our canine application as well as payment in full or at least 50% of the purchase price if the canine is not ready to go. While we do permit the buyer to purchase a specific pet if it is listed and available, individual puppies are never assigned 100% until they are ready to go and have been paid in full. Please call ahead of time to ensure we have what you desire to purchase.

ARE YOU BUYING A PET 'AS IS' ? _________ PLEASE CHECK YES IF YOU ARE NOT PURCHASING A GENETIC HEALTH WARRANTY. *All pets are sold "as is" if a genetic health warranty has not been purchased and/or is not included in a purchase price. If a genetic health warranty is not purchased, we do provide a 30 day grace period to ensure there are no genetic, life threatening health issues with the purchased pet. "As is" means that the pet is being purchased without any amenities, warranty and as it is at the time of purchase. No warranty is provided, insenuated or given if the buyer has not purchased one of our genetic health programs or if it is not included in the price of the listed pet and the grace period has ended. PLEASE INITIAL HERE THAT YOU UNDERSTAND THE ABOVE: _______________

ARE YOU ADOPTING A SPECIAL NEEDS CANINE? ______________________

*A special needs canine is sold at a reduced price with no guarantee implied, insinuated or given unless the canine has been purchased under one of our genetic health programs. *A special needs canine is listed with its specific issue upon our website as we know it. The buyer is aware of the canine's issue prior to purchase and agrees to accept the purchased canine with its specific special need, "as is".

ARE YOU ADOPTING A FREE, SENIOR OR OLDER ADULT CANINE? ___________________

* Although a canine may be sometimes advertised as "FREE", we require the FREE canine to be spayed and neutered if this procedure has not yet been completed. PAYMENT TO OUR VETERINARIAN FROM THE ADOPTEE is REQUIRED for this procedure and the canine will be PICKED UP by the adoptee AFTER the procedure has been completed, at our VETERINARIAN'S OFFICE unless you have submitted an additional $450 to cover POST OP care. ALL FREE canine advertised are adopted AS IS. There is no warranty or guarantee implied, insinuated or given with any free adoptable canine.

IS YOUR PET BEING PROVIDED A HEALTH CERTIFICATE PRIOR TO CANINE POSSESSION? ______

*A health certificate is required for all shipped pets at the buyer's cost unless included in a purchased price program the buyer has elected or unless it is so notated in the advertised price. The seller requires all purchased pets to receive a health certificate either prior to possession or within 48 hours of possession. The buyer is responsible for the costs of a health certificate if the certificate is not included or listed in the advertised price. All veterinarian services, once provided to the purchased pet, are non refundable and non transferable for any reason. THE BUYER IS REASONSIBLE FOR ALL VET SERVICES RENDERED TO A PURCHASED CANINE UNLESS SUCH SERVICES ARE INCLUDED IN THE PRICE OF THE CANINE. If a health certificate was NOT included in the purchase of a canine, the buyer agrees to provide the seller with proof of a health certificate by their vet within 48 hours of purchase. PLEASE INITIAL HERE: _________

IF PURCHASING A CANINE FIVE MONTHS OR OLDER, DO YOU AGREE TO REIMBURSE THE SELLER FOR ALTERING FEES PRIOR TO POSSESSION? _____ *The seller requires all purchased female canine to be spayed prior to personal pick up or prior to shipment/delivery. A buyer must agree to neuter a purchased male if the procedure has not already been completed, within a reasonable amount of time. All altered purchased pets are provided updated vaccines, a health certificate and a rabies certificate/tag which is not included in the price of the purchased pet unless the buyer has elected to purchase a genetic health program or unless the above has been included in the price of the canine by the seller. Such fees must be reimbursed to the seller at the time of personal pick up or prior to shipment/delivery. The seller will provide the buyer with veterinarian documentation as there are no hidden fees. ALLFEMALE CANINE FIVE MONTHS OR OLDER MUST BE PAID IN FULL PRIOR TO ANY OF THE ABOVE VET SERVICES BEING RENDERED. INITIAL HERE: ___________________

PLEASE BE AWARE THAT SERVICES PROVIDED TO A PURCHASED, ASSIGNED PET BY OUR VETERINARIAN ARE NON REFUNDABLE/NON TRANSFERABLE FOR ANY REASON. PLEASE INITIAL HERE: __________ *Please be aware that if our vet has provided their services to your purchased, assigned pet, that their vet fees are non refundable and non negotiable. Unfortunately, our vet will not provide free veterinarian services and they do require that their services are paid regardless of outcome of any testing, surgeries or services provided.. We will not assign any pet to any buyer that has an obvious, visible impairment unless the buyer is aware ahead of time that they are purchasing a pet with a "special need" or specific "impairment". Some impairments are not visually noticeable by us as the seller or by our vet and some health issues can not be visually seen with the naked eye. Should an impairment be found by our vet through testing, surgery or xrays, we immediately contact the buyer and give them the option of accepting the original purchased pet "as is" or accepting an exchange/replacement pet as an alternative. Sales of any of our available pets are never contingent upon vet services provided and there are no refunds granted for any reason. We agree to either immediately exchange or replace a pet upon first availability or place the buyer on a waiting list if an exchange/replacement pet is not immediately available. Vet services can NOT be duplicated on the exchange/replacement pet or transfered to the exchange/replacement pet because our vet does NOT provide their services for free. The buyer is responsible for reimbursing the seller for all vet fees at the time of personal pick up or prior to shipment/delivery. Vet fees are non-negotiable.

WHAT TIME FRAME ARE YOU REQUESTING THIS CANINE?: ___________________________________

* We can not always provide a pet to our customers exactly when desired. Exact time frames are not guaranteed. We will, however, try and match you with the time frame you seek, as quickly as possible. If the time frame does not agree with the buyer and the buyer cancels their sale, there are no refunds given for any reason.

ARE WE SHIPPING? IF YES, WHICH AIRPORT ARE WE SHIPPING TO? (must be an international airport; sorry, we do not ship to regional airports.) : __________________________________________________________

*IF WE ARE PROVIDING SHIPPING ASSISTANCE FOR THE BUYER'S PURCHASED PET, THERE IS AN ADDITIONAL SHIPPING ASSISTANCE FEE REQUIRED BY THE SELLER THAT DOES NOT INCLUDE AIR FARE. THIS FEE STARTS AT $375.

(Shipping fees or other provided service fees are non refundable and non transferable, at any time, for any reason once submitted to the seller. During the summer months, shipping may not be available unless the temperature is less than 85 degrees in all destination areas. WE CAN NOT GUARANTEE SHIPMENT DATES DURING EXTREME WEATHER. As of 9-11, 2005, Airfare is C.O.D; Our shipment assistance fee starts at $375 to cover a small to large sized crate, transportation fees and expenses regarding shipping assistance and must be paid to us prior to shipment. X-large Crates for adult sized, large dogs are an additional $100. The assistance fee does NOT include airfare. All airfare is c.o.d. and paid by the buyer at the time of pick up at the destination airport. We are 120 miles RT from the airport, CLICK HERE for further details. There are no refunds on any changes made, once payment has been accepted by us, regardless of issue. *SHIPMENT ASSISTANCE FEE WILL VARY and can increase IF THE CANINE IS AN ADULT LARGE SIZED DOG OR PUPPY THAT REQUIRES AN EXTRA LARGE CRATE. Shipping dates/times ARE NOT guaranteed and are subject to change either due to extreme weather, airline issues or personal issues. When a pet is ready to go, we make shipping arrangements and provide the buyer with a shipment assignment number. Weather issues can cause delays on shipping dates that is beyond our control. The buyer will be held legally responsible and liable for all shipment fees and expenses to include RT (round trip) airfare if the purchased canine is returned to us by the airlines due to the buyer's refusal to pay the airfare at the destination point. We have no control over airline fees/prices and do not know in advance what the airlines is going to charge until the pet is actually checked in with the airlines on the day of shipment.

ARE WE PERSONALLY DELIVERING? ____________. (DELIVERY FEES ARE NON-REFUNDABLE ONCE PAID. Personal delivery must be discussed and pre-approved by us before delivery will occur. Personal delivery fee will vary depending upon actual mileage, time and actual expenses. ALL PERSONAL DELIVERY FEES ARE PAID UP FRONT, along with this application, WITH A POSTAL MONEY ORDER. NO CHECKS ARE ACCEPTED FOR DELIVERY FEES UNLESS IT IS FROM BOA (Bank of America). PERSONAL DELIVERY IS TIME PERMITTING AND FEES WILL VARY. ) We can on occasion provide delivery to the Charlotte-Douglas International Airport for an additional fee if you are flying back with your purchased pet. Fees must be paid ahead of time unless waived by the seller. Please be aware that all airlines require a health certificate before your pet can board their airplane.

WHAT METHOD OF PAYMENT ARE YOU SUBMITTING? : _________________________

*Cancellations by the buyer at any time once payment or a deposit has been submitted and accepted will cause the buyer to forfeit the pet and any monies paid to the seller, regardless of reason for cancellation. If vet services has been provided to a purchased, assigned pet, the buyer is responsible for reimbursing the seller for all aid fees. PLEASE INITIAL HERE:_____________

IF SUBMITTING YOUR DEPOSIT/PAYMENT VIA WESTERN UNION, WHAT IS THE MONEY TRANSFER CONTROL NUMBER?:_________________________________ *We will call you immediately after payment has been received. All deposits/payments are non refundable for any reason once accepted by the seller. Any balance owing MUST be paid in cash at the time of personal pick up. ALL CANINE THAT ARE FIVE MONTHS OR OLDER MUST BE PAID IN FULL PRIOR TO POSSESSION SO THAT IT CAN BE ALTERED. Be aware that Western Union can be costly, but very quick. We encourage the buyer to make a direct deposit into our account for inexpensive, expedited service.

IF SUBMITTING YOUR DEPOSIT/PAYMENT VIA PERSONAL CHECK, WHAT IS THE CHECK NUMBER AND BANK NAME?: __________________________________________ *PERSONAL CHECKS WLL NOT BE ACCEPTED UNLESS IT IS FROM BANK OF AMERICA. PERSONAL CHECKS or CASHIER CHECKS FROM ANY OTHER BANK WILL CAUSE YOUR PET TO BE DELAYED FOR UP TO 60 DAYS TO ENSURE THE CHECK IS LEGIT AND CASHABLE. Sorry, we do not accept store money orders for any reason.

Please submit an american postal money order if you do not bank with the above facilities or you can send your payment via western union. ALL CANINE THAT ARE SIX MONTHS OR OLDER MUST BE PAID IN FULL PRIOR TO POSSESSION SO THAT IT CAN BE ALTERED. We do encourage all buyers to make a direct deposit to our account for expedited service.

IF SUBMITTING YOUR DEPOSIT/PAYMENT VIA AMERICAN POSTAL MONEY ORDER, WHAT IS THE MONEY ORDER NUMBER? : __________________________________ *If you are seeking immediate purchase, please submit an American Postal Money Order and send OVER-NIGHT EXPRESS U.S. MAIL. Please call us with the tracking number after you obtain one. All payments/deposits are non refundable once accepted by the seller. ALL CANINE THAT ARE SIX MONTHS OR OLDER MUST BE PAID IN FULL PRIOR TO POSSESSION SO THAT IT CAN BE ALTERED.

IF YOU ARE SENDING THIS APPLICATION AND YOUR NON REFUNDABLE DEPOSIT/PAYMENT TO US VIA FED-EX, UPS OR EXPRESS MAIL, WHAT IS THE TRACKING NUMBER? : ____________________________________________ *We will contact you once payment has been received. If you are only submitting a deposit, all balances are paid in cash at the time of personal pick up. If your pet is being shipped, all fees must be paid in full prior to shipment. We do not allow any pets to leave our custody until they are paid in full.

TOTAL AMOUNT YOU ARE SUBMITTING? : _______________

(PLEASE ENSURE THAT YOU ADD 8% NC SALES TAX TO YOUR TOTAL. ALL SUBMITTED PAYMENTS ARE NON REFUNDABLE/NON REIMBURSEABLE FOR ANY REASON, regardless of issue. ANY MONIES SUBMITTED BY THE BUYER TO THE SELLER IN ORDER TO SECURE A CANINE OR TO BE PLACED UPON A WAITING LIST IS ACKNOWLEDGEMENT BY THE BUYER THAT THE BUYER UNDERSTANDS, ACCEPTS AND AGREES TO ABIDE BY THE SELLER'S NO REFUND/NO REIMBURSEMENT/NO FINANCIAL AIDE PURCHASE POLICY AND THE BUYER UNDERSTANDS THAT THIS APPLICATION IS A CONTRACT TO PURCHASE FROM THE SELLER. THE SELLER'S POLICY IS ENFORCED WHETHER BE IT IN WRITING, UPON THIS WEBSITE, BE IT VERBAL AND AS IT IS STATED UPON THIS CANINE APPLICATION. THIS APPLICATION AND ALONG WITH A NON REFUNDABLE PAYMENT IN FULL MUST BE RECEIVED BEFORE A PET IS ALLOWED TO LEAVE OUR PHYSICAL CUSTODY.. REFUNDS ARE NOT GRANTED FOR ANY REASON SHOULD A BUYER DECIDE TO CANCEL WITH THE BUYER AT ANY TIME ONCE PAYMENT HAS BEEN RECIEVED BY THE SELLER. ALL SALES ARE FINAL SALES. UNLESS A WARRANTY PROGRAM HAS BEEN PURCHASED, NONE IS INSENUATED, GIVEN OR IMPLIED..however, we do provide a ten day grace period to ensure there isn't any life threatening health issues with the purchased pet that was not visible at the time of purchase. If a life threatening health issue occurs within ten days, we will provide a replacement/exchange pet upon first availability and upon receiving a statement from the buyer's veterinarian showing the reason for the life threatening health issue. ANY PAYMENT SUBMITTED AS WELL AS THE ASSIGNED PET ARE FORFEITED BY THE BUYER IF THE BUYER CANCELS THEIR SALE AT ANY TIME AFTER THE SELLER HAS ACCEPTED PAYMENT FROM THE BUYER, REGARDLESS OF REASON FOR THE CANCELLATION. ALL BUYERS CAN BE PLACED ON A WAITING LIST IF AN UNFORSEEN ISSUE HAS OCCURED WITH THE BUYER. NO EXCHANGES ARE PERMITTED ONCE A PET HAS LEFT OUR PREMISES UNLES PRE- APPROVED BY THE SELLER. PET RETURNS ARE WITHOUT A REFUND AND MUST BE PRE- APPROVED BY THE SELLER. ALL SERVICES RENDERED FOR A PURCHASED PET ARE NON REFUNDABLE/NON TRANSFERABLE FOR ANY REASON EITHER PRIOR TO POSSESSION OR AFTER POSSESSION. THE BUYER IS RESPONSIBLE FOR ALL VET SERVICES RENDERED TO AN ASSIGNED, PURCHASED PET AND MUST REIMBURSE THE SELLER FOR SUCH FEES IN FULL IF THEY ARE CANCELING A SALE FOR ANY REASON. INITIAL HERE: _______________

WHICH GENETIC PRICE PROGRAM, HAVE YOU SELECTED IF YOU HAVE OPTED TO PURCHASE A GENETIC HEALTH WARRANTY? : ________________ INITIAL HERE IF YOU ARE BUYING A PET WITHOUT A GENETIC HEALTH WARRANTY: ________

*Deposit amount is payment in full if the canine is ready to go. Deposit amount is 50 percent of the complete total if the pet is not ready to go.

(Please include 8% NC sales tax) IN YOUR TOTAL: ___________________

*Sales tax must be included regardless of program and regardless of what state you reside in. Sales tax is subject to change as per the state of North Carolina. The puppy is being purchased from NC, therefore NC sales tax applies to all buyers.*

DO YOU AGREE TO SPAY/NEUTER BY AGE 6 MONTHS IF YOU ARE PURCHASING A PET YOUNGER THAN AGE SIX MONTHS? ____________* PLEASE DO NOT SUBMIT PAYMENT FOR SPAYING OR NEUTERING IF YOUR REQUESTED CANINE IS NOT AT LEAST 5 MONTHS OF AGE. IF YOUR PURCHASED PET IS TOO YOUNG FOR ALTERING, ASK THAT ALL CANINE PURCHASED ARE SPAYED OR NEUTERED AS SOON AS THEY ARE OLD ENOUGH UNLESS WE HAVE PRE-APPROVED A BREEDER TO PURCHASE FOR BREEDING PURPOSES. ALL CANINE ARE SOLD AS PETS ONLY. DOGS SOLD TO A BREEDER ARE NEVER IMPLIED AS BEING QUALIFIED BREEDING DOGS. All purchased pets at least six months of age are spayed or neutered prior to personal pick up or prior to shipment/delivery. Such services are not included in the price of any canine unless the buyer has elected to purchase one of our genetic health programs or unless it is noted in the advertised/listed price upon our website. All such services are non refundable/non transferable once provided to the assigned canine regardless of issue. The buyer is responsible for all vet services once rendered to the assigned, purchased pet. If you have not purchased a program that offers altering services or if the price does not include this amenity, such services MUST be paid at the time of personal pick up or prior to shipment/delivery. Fees may vary for altering depending upon actual weight of the purchased pet as well as other services performed for the pet by our veterinarian.

PLEASE TELL US ABOUT YOUR SELF/FAMILY/CHILDREN (their ages/gender/activity level):

(this helps us determine which puppy to select for you if we are shipping):________________________________

_____________________________________________________________________________________________

CHILDREN DO NOT ALWAYS TAKE RESPONSIBILITY FOR THEIR NEW PET AND THIS TASK USUALLY FALLS UPON THE PARENT ONCE THE NOVELTY WEARS OFF. DO YOU AGREE TO TAKE FULL RESPONSIBILITY FOR YOUR NEW PET IF YOUR CHILDREN NO LONGER ARE WILLING TO DO SO? _____

IF YOUR ANSWER IS NO, WHO WILL BE RESPONSIBE FOR YOUR NEW PET?________________________________________________________________________________________

*If a pet has been purchased for a child under the age of 18 years of age, please be aware that we will hold the parent/s liable and responsible if we discover the new pet has been abandoned where care can not be provided to the purchased pet. We require all parents to ensure that their new pet finds a loving, responsible home if it is no longer wanted or able to be cared for. We are not always able to accept a returned pet if the pet does not work out for the buyer. There are NO exchanges permitted once the pet has left our premises unless pre-approved by the seller.

WILL THERE BE SOMEONE HOME WITH THE PUPPY?: yes: ________ No___________

If not, how many hours do you anticipate you will be gone?: ________________ Please explain:______________

______________________________________________________________________________________________

IF YOU WILL BE GONE FOR EXTENDED PERIODS OF TIME, WILL SOMEONE BE AVAILABLE TO CARE FOR YOUR PUPPY/DOG?_________________

DO YOU ALREADY HAVE A VETERINARIAN APPOINTMENT SET UP FOR YOUR CANINE?: YES:______ NO:_____

NAME OF VET (please include phone number/city/state) ?: _________________________________________________________

________________________________________________________________________

(If you do not have a Veterinarian lined up, please take the time to locate one prior to your canine arrival.)

DO YOU AGREE TO PROVIDE YOUR PURCHASED PET WITH A PERMANENT HOME UPON POSSESSION?

________

DO YOU AGREE TO FIND YOUR PURCHASED PET A LOVING, PERMANENT, SUITABLE GOOD HOME IF YOU ARE NO LONGER ABLE TO KEEP HIM OR HER; NO LONGER HAVE THE DESIRE TO KEEP HIM OR HER OR IF WE ARE NOT ABLE TO ACCEPT HIM OR HER BACK AS A RETURNED PET? ________

DO YOU AGREE TO NOT RELINQUISH YOUR PURCHASED PET TO A BOARDING FACILITY? ANIMAL SHELTER? HUMAN SOCIETY? RESCUE AGENCY IN THE EVENT YOU NO LONGER DESIRE OR ARE NO LONGER ABLE TO KEEP YOUR PURCHASED PET? ___________

* We are not always able to accept a purchased pet back if you no longer desire to keep your pet, however, you are required to give US the first option of being able to accept the pet back before relinquishing your purchased pet.. You are required to contact us IMMEDIATELY if you are NOT able to provide for your purchased canine. Unfortunately we do not always have the room or financial ability to accept a returned pet. In the event we are unable to accept a returned pet, we require the buyer to find a suitable home for the purchased pet. Suitable home does NOT mean a rescue group, shelter or humane society. A Suitable home means finding someone who will provide a stable, permanent, loving home for the purchased pet. If the buyer decides to relinquish ownership of their purchased pet and if we are able to accept its return, there are no refunds implied, insinuated, given or available for any reason whatsoever. We, the seller, are not responsible for locating a new home for your purchased pet once he/she has been removed from our premises and if we are not able to accept the pet back. An exchange MUST be pre-approved by us, the seller, if such a need occurs. Anyone who relinquishes one of our purchased pets with a shelter, boarding facility, humane society or rescue group of any kind will be held legally responsible for all expenses incurred if we are nofified by such facilities that this has occurred and we are able to obtain the pet back into our custody.

PLEASE INITIAL HERE THAT YOU UNDERSTAND WE ENFORCE THE INFORMATION UP ABOVE: ________

DO YOU HAVE OTHER PETS?: _____________

IF SO, WHAT KIND? AGES?: ____________________________________________

IF YOU HAVE OTHER PETS, HOW OLD ARE THEY ? WHAT GENDER ARE THEY ? WHAT TEMPERAMENTS DO THEY HAVE? ARE THEY OTHER PET FRIENDLY? _________________________________________________________________________________

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ARE YOU EMPLOYED? __________ *If you are not employed, we will require proof of some sort of income to show that you have the funds available to provide essentials for the purchased pet's welfare.

IF YOU ARE EMPLOYED, WHERE ARE YOU EMPLOYED ? ______________

IF SO, HOW LONG HAVE YOU BEEN EMPLOYED WITH THIS COMPANY? ___________

WHAT IS YOUR DRIVER'S LICENSE NUMBER (PLEASE LIST THE STATE YOUR LICENSE HAS BEEN ISSUED? __________________________ (we only need your license information if you are submitting payment with a personal check NOT from BOA, Wacchovia or Sun Trust.)

WITH WHAT STATE IS YOUR DRIVER'S LICENSE ISSUED FROM? ___________________________

*Please attach a copy of your drivers' license with this application if you are submitting payment with a personal check NOT from BOA. If you have submitted a check as payment and you have submitted a copy of your driver's license, your address MUST match the address that is shown on your driver's license.

HAVE YOU EVER OWNED A CANINE BEFORE?: _______________

*If you are not experienced in canine ownership, we highly encourage you to provide obedience training for your purchased pet so that you and your pet can have a lasting, successful relationship together.

IF NOT, HAVE YOU EVER HAD ANY EXPERIENCE WITH A CANINE OR OTHER ANIMALS?: __________

PLEASE EXPLAIN YOUR EXPERIENCES: _______________________________________________________

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WE HIGHLY RECOMMEND ALL PURCHASED PETS TO BE ENROLLED IN SOME SORT OF OBEDIENCE CLASSES OR RECEIVE PROFESSIONAL TRAINING IF YOU ARE NOT AN EXPERIENCED CANINE OWNER. IF YOU ARE AN INEXPERIENCED CANINE OWNER, ARE YOU GOING TO PROVIDE ESSENTIAL TRAINING TO YOUR PURCHASED PET SO THAT BOTH YOU AND YOUR PET WILL HAVE A SUCCESSFUL, LASTING RELATIONSHIP? ______

IF NO, PLEASE TELL US WHY YOU WILL NOT BE PROVIDING TRAINING FOR YOUR PET?

__________________________________________________________________

*If money is an issue, the YMCA does on occasion provide low cost obedience training classes for your pet or check with your vet for information on available training classes.

WILL YOUR PET ATTEND DOGGIE DAY CARE?: __________________________

IF SO, WHERE? : ____________________________________________________________________________

WHERE WILL YOUR PET BE SLEEPING AT NIGHT?: _________________________________________

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WHAT ARE YOUR YARD CONDITIONS? DO YOU HAVE A FENCED YARD TO ALLOW SAFE PLAY TIME FOR YOUR PET ? (if not, what are your plans for playtime or outdoor activities?): _______________________________________________________________________

WHAT ARE YOUR EXPECTATIONS OF YOUR PURCHASED PET ?: _______________________________

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*PLEASE BE AWARE THAT OLDER ADOPTED PETS NEED TIME, PATIENCE AND UNDERSTANDING. PLEASE KNOW THAT YOUR NEW PET MUST BE GIVEN PROPER TIME TO SETTLE IN, ADJUST AND GET TO KNOW YOU, YOUR FAMILY AND HIS/HER NEW SURROUNDINGS. WE HIGHLY RECOMMEND OBEDIENCE TRAINING FOR THE DOG AND THE FAMILY FOR SUCCESSFUL OWNERSHIP.

HAVE YOU EVER BEEN CONVICTED OF ANIMAL CRUELTY?: __________ IF SO, WHAT WERE THE CIRCUMSTANCES?:__________________________________________________________________________

HAVE YOU EVER BEEN DENIED AN ADOPTION OF ANOTHER CANINE THROUGH EITHER AN ADOPTION AGENCY OR VARIOUS RESCUE AGENCIES? ____________ IF YES, PLEASE LIST THE AGENCY'S PHONE NUMBER AND ADDRESS AND TELL US WHY YOU BELIEVE YOU WERE DENIED THE ABILITY TO ADOPT FROM THEM ?____________________________________________________________________________

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DO YOU OWN OR RENT YOUR HOME?: __________________

IF YOU RENT, HAVE YOU MADE SURE THAT YOU ARE ALLOWED PETS IN YOUR HOME?: ________

*CHECK N/A IF THIS DOESN'T APPLY TO YOU.*

IF YOU RENT, DO YOU HAVE SIZE LIMITATIONS REGARDING A DOG?:__________________________

*CHECK N/A IF THIS DOESN'T APPLY TO YOU.*

IF YES, WHAT ARE YOUR SIZE RESTRICTIONS?:________________________________________________

DO YOU AGREE TO HAVE YOUR PET SPAYED/NEUTERED IF YOU HAVE PURCHASED A PET YOUNGER THAN SIX MONTHS OF AGE ?: ___________ *We require all purchased pets to be spayed/neutered before leaving our custody if they are five months of age or older. The buyer is responsible for vet services rendered unless such fees are included in the purchase price.*

DO YOU AGREE TO PROPERLY CARE FOR YOUR PURCHASED PET ?: _______

DO YOU AGREE TO BE A RESPONSIBLE, LOVING PET OWNER?: ____________________

DO YOU AGREE TO CONTACT US IF YOU ARE UNABLE TO CONTINUE TO PROPERLY CARE OR OWN YOUR GOLDENDOODLE?: ___________________

DO YOU AGREE TO NEVER ALLOW YOUR CANINE TO ROAM FREE, IN YOUR NEIGHBORHOOD, UNSUPERVISED?: ________________

DO YOU AGREE TO CONTINUE VACCINATIONS, DEWORMINGS AND YEARLY SCHEDULED ROUTINE VET VISITS FOR YOUR PURCHASED PET ?: ___________ *Our purchase policy requires copies of vet services sent to us periodically for your file. We will refuse to assist any buyer who does not provide us with copies of health care provided to the purchased pet*

YOUR signature constitutes ACKNOWLEDGEMENT that the information placed upon this application is true and accurate. Your signature constitutes ACKNOWLEDGEMENT that you, the buyer understand and agree to abide by the seller's application to purchase; the seller's purchase policy and that you understand the seller has a no refund, final sales policy that is fully enforced.

Please print AND sign your name (the buyer) in full here: ________________________________

CANINE APPLICATION

This application is not an online application. It must be printed out by you before it can be filled out. This application can be faxed to us providing you have sent your payment to us via Western Union. If you intend to submit this application via fax, please call ahead of time so that we can turn our fax machine on.

*This application was slightly modified on Jan 4, 2010.

click here for more details.

THIS APPLICATION IS A CONTRACT TO PURCHASE AND IS LEGALLY BINDING BY THOSE WHO SIGN IT. OUR APPLICATION IS A CONTRACT TO PURCHASE AND IS FULLY AND LEGALLY ENFORCED.

Please print out this application to submit along with your deposit or payment in full:

Mike Gerrish

165 Four Lakes Dr.

Cleveland, NC 27013

704-278-DOGS (3647)

Western Union number : 1-800-325-6000

Do you twitter? YES _______ NO _______

Twitter User name:___________________