Name *

Address *

Website

Phone *

E-Mail *

How did you hear about Eco Staffords? *

Why do you wish to own a Staffordshire Bull Terrier? Please be specific. *

Have you previously owned a Staffy? * YesNo

Have you previously owned any other type of dog? YesNo

Please describe your family make up. Adults, children and any other pets. *

Please describe your residence and where the puppy will spend its time. i.e. inside, outside, day, night etc. *

Is your yard fenced? YesNo

What activities do you plan to engage in with your Staffy? (I.e. companion, obedience, conformation, agility etc.) *

Do you have a gender preference? MaleFemaleNo Preference

Are you a member of a dog club? YesNo

Any additional pertinent information you would like to add? Any questions or comments?

3 + 1 = ?Please prove that you are human by solving the equation *