Hickory Hollow Llewellin Setters - Adoption Application

Page Updated 06/17/10

Thank you for your interest in a Hickory Hollow Llewellin Setter. We greatly appreciate your willingness to provide us with some information about yourself. This application is tailored toward a puppy purchase, but actually serves two purposes. We will use this data in our selection of potential new families for our rescue dogs as well as our puppies and to help to match you with a puppy that also meets your qualifications.

Once received, we will acknowledge all adoption applications in a timely manner. In the event that we feel your application meets our standards, you will be placed on our "adoption approved" list and will be allowed to choose a puppy from any current or upcoming litter of your choice and will also be eligible as adoptive parents for any of our rescue dogs.

We look forward to hearing from you!

**All the information submitted will be held strictly confidential and is for our business use only. We will not share your information with anyone without obtaining your permission first.

Date: (MM/DD/YYYY)

General Information:
How did you hear about us?
Why did you choose us as your breeder?
I am interested in: (check all that apply)	Adopting a puppy Adopting a rescue dog Fostering a rescue dog

	Personal Information: (fields marked with * are required)
*	Name: (you)
	Name: (spouse/other)
*	Street Address:
*	City:
*	State:	* Zip:
*	Phone (home):
	Phone (mobile):
*	E-Mail:
	Age:
	Occupation:
	Children at home?	Yes No Age(s):
	Please take this opportunity to tell us more about you and your family.

	Property Details: (fields marked with * are required)
*	In what type of area is your home located?	City Suburbs Country
*	What type of home do you live in?		If other, explain:
*	Do you rent or own your home?	Other?
	If you rent, what would you do with your dog if you had to move?
*	What is the size of your property?	Additional description:
*	Do you have a fenced area in your yard?	If so, please describe:

Puppy Preferences:
If there is a specific puppy we have "available" to reserve, please give us the details.
Available pup:	Litter ID: Puppy #: Call Name:

If you want to reserve a pup from a future litter, please tell us your preferences.
Gender:
Color:	Any color, No preference (Select from below if you have specific color preferences)
	White / Black and ticked White / Orange and ticked White / Chestnut and ticked Tri-color (White / Black / Tan) Chestnut Tri-color (White/Chestnut/Tan)	Blue Belton Orange Belton Chestnut Belton Tri-Belton Chestnut Tri-Belton
Parents: (leave blank if no specific preferences)	Sire: Dam:
Timeframe?
Delivery Method: See Methods	If Personal Delivery, Air Shipment or Other, please indicate where the delivery will be made.
Additional Puppy Preferences: (list any specifics or deal-breakers here)

Breed Related:
Would this dog be your first Llewellin Setter?
What qualities are you looking for in a dog?
What are the reasons you have chosen a Llewellin Setter? (Please check all that apply)	Family Companion Hunting Field Trials Breeding Show Ring
If you are a hunter, what other breeds have you hunted with?

Hunting Background:
Are you an upland hunter?
If so, please answer the following, otherwise please skip to the next section.
What upland birds do you hunt?	Pheasant Quail Grouse Woodcock	Huns Ptarmigan Chukar Other
About how many times per year do you hunt?

Are you a member of any hunt club / bird preserve or training facility?
If so, please describe:

	Ownership: (fields marked with * are required)
	Have you previously owned dogs?
	Who is your veterinarian? (Please provide name and contact #)
	What did you vaccinate for?
	What brand of food did you feed?	If Store Brand or Other, what type?:
	How often did you feed?
	Do you currently have any other pets at home?
	If so, what species? (If dogs, please also specify breed)
*	Are you planning to spay or neuter this dog?	If undecided, please explain why:
*	Will this dog live primarily inside or outside?
	If outside only or both indoors and outdoors, please describe outdoor living quarters.	If Other, please describe:
	Where will the dog be when you are not at home?
	Where will the dog be when you are at home?
	Will you train this dog?
	What types of training will you do? (Please check all that apply)	Hunting Field Trials Obedience Other
	Do you have any dog training experience?	If so, please explain:
*	Please provide two personal references and their contact info:	1. 2.

	Puppy Extras: (fields marked with * are required)
*	Do you want to register your puppy with the American Field in the Field Dog Stud Book (FDSB)? See FDSB Registration...
*	If you want FDSB registration, do you also want to order an "official" pedigree at the same time? If so, make your selection at the right.
*	Are you interested in having your puppy microchipped? See microchipping...