Application for a Chase-n-Pom puppy
(* denotes required fields)
Name*
Street
 City
 State
 Zip
Telephone*
 Mobile phone
E-mail address*

Did you see the puppy of your dreams on our site? If so, puppy's name:
If not, please describe your new baby:
Please list other members of your family (including fur kids) and ages:

Do you rent/own?
(If you rent please be aware you may need to get permission from your landlord.
Please make sure you do this before you fall in love with one of our babies.)
Rent Own
Have you ever owned a pom before?
Yes No
If not, why have you chosen a pomeranian?
Have you ever relinquished a pet to an animal shelter? If so, please explain the circumstances.
Are you a member in any dog or pet-related organizations? (e.g. AKC, ASPCA, Kennel Club, etc.)

References (one must be your veterinarian's office)
1. First name

Phone
 Address

Relationship
2. First name

Phone
 Address

Relationship
3. First name

Phone
 Address

Relationship

Please give us a brief essay on "A day in the life of my pom."

 

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