Puppy Application

1. Name

2. Address

3. Email Address

4. Phone Number

5. How did you hear about C & HM Pomeranians?

6. Do you have any pets currently? If so, how many?

7. Do you have any kids?

8. Why a Pomeranian?

9. What color Pomeranian are you interested in?

10. Have you ever owned a dog? 10. Have you ever owned a dog? Yes No

11. Have you ever owned a Pomeranian? 11. Have you ever owned a Pomeranian? Yes No

12. Is anyone in your family allergic to dogs? 12. Is anyone in your family allergic to dogs? Yes No

13. Will you educate yourself on a Pomeranians needs before you receive a Pomeranian? 13. Will you educate yourself on a Pomeranians needs before you receive a Pomeranian? Yes No

14. Does everyone in the family agree on getting a Pomeranian? 14. Does everyone in the family agree on getting a Pomeranian? Yes No

15. Have you ever returned a pet to the breeder? 15. Have you ever returned a pet to the breeder? Yes No

16. Have you ever given away an animal? 16. Have you ever given away an animal? Yes No

17. Have you ever taken a pet to a pound or shelter? 17. Have you ever taken a pet to a pound or shelter? Yes No

18. If you answered "Yes" any of the previous questions labeled 12-14, what were the circumstances?

19. The Breeder cannot guarantee the weight of a Pomeranian, the Breeder can only give an estimate. 19. The Breeder cannot guarantee the weight of a Pomeranian, the Breeder can only give an estimate. I Understand and Agree to These Terms and Conditions I DO NOT Understand and Agree to These Terms and Conditions

20. The Breeder does NOT give refunds unless for health issues. 20. The Breeder does NOT give refunds unless for health issues. I Understand and Agree to These Terms and Conditions I DO NOT Understand and Agree to These Terms and Conditions