A Bravenet.com Contact Form

We want a Maplelane Golden!

Tell us a bit about yourself and your family, please fill out the questions below.

Name *

Postal Address *

Email Address *

Phone Number *

Home Status * Own my own home Rent

Do you have a securely fenced yard

If rent have you spoken to the landlord of your interest in a puppy Yes No

Marital / Significant other Status Married / Live Together Single

Your Occupation

Spouse's occupation

Does your spouse / significant other share your desire for a puppy Yes No

Do you have children, if so how many and ages *

Have you had a Golden in your family before Yes No

Have you familiarized yourself with the Golden Breed? Yes No

Why have you chosen a Golden?

Do you currently have any other pets? Please include type.

Have you ever had to re-home one of your pets, if yes please provide details. *

Veterinarian's Name / Clinic

Can your Vet be contacted for a reference. Yes No

Veterinarian contact Info

Who will care for your puppy during working hours

Who will the primary caregiver for your new puppy

What sex of puppy are you looking for? Female Male

Do you have a colour preference

Do you have an exercise and housing plan for your new Golden, please provide details

What is your main goal for wanting a Golden

Do you agree to have your Golden spayed/neutered Yes No

Are you planning to attend obedience/socializing classes with your puppy Yes No

Are you in favour of crate training Yes No

Please provide any additional information you feel is important for us to know while choosing a parent to one of our Maplelane Goldens