Your Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

What is your living arrangement? *

Rent

Own

Other

Does your residence have a fenced yard? *

Yes

No

How is your house heated and cooled? *

Heat only

Heat and Swamp Cooler

Heat and AC

Do you have children? *

Yes

No

Are there any other pets in your home? *

Dog

Cat

Other

N/A

Are your other pets spayed or neutered?

Yes

No

N/A

When are you looking to get a Bulldog? *

6-9 Months

9-12 Months

12-18 Months

24 Months

Other

Have you owned a Bulldog before? *

Yes

No

Are you looking for a pet or a show dog? *

Pet

Show Dog

Do you want a Male or Female? *

Male

Female

Do you have a preference in color? *

White

Red

Fawn

Brindle

Piebold

Are you interested in breeding your dog? *

Yes

No

Where will your dog live or spend most of its time? *

Home Alone

Home with a care taker

Licensed Dog Care Center

Who will be responsible for caring for the Bulldog? *

Self

Spouse

Kids

Family member outside of home

Have you ever re-homed a pet? *

Yes

No

Are you aware of the expenses that come along with owning a Bulldog? *

Yes

No

Have you or any immediate family member been tested for Dog allergies? *

Yes

No

How did you hear about Bane Bulldogs? *

Personal referral ( please list whom referred you in comments)

Google Search

Facebook

Dog Show Contact

Other