Application Form Home » Jack Russell Nursery » Application Form Puppies Future Litters Application "*" indicates required fields X/TwitterThis field is for validation purposes and should be left unchanged.Name*Telephone Number*Email Address* Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code What kind of area do you live? City, busy street, country?What qualities are you looking for in a puppy?What are you looking for: male/female? smooth/broken/rough? color?How important are markings? or is temperament more important to you?Do you agree with selecting a puppy based on temperament being most important?How many hours will your puppy be alone during the day?Please note if you have children in the home and their age.Do you have other dogs? Please list sex/breed or other animals in your home.Do you agree with training your puppy with positive reinforcement and force free methods?Do you have a fenced yard? If not, what are your plans to keep your puppy safe?Connemara Terriers are devoted companions. Are you prepared and ready for a constant "shadow".Additional information you would like us to know. By checking this box, you acknowledge you have read and understand our policies. By checking this box you agree to spay/neuter your puppy. We do not breeding rights. By checking this box you, you acknowledge that the deposit is non-refundable but transferable up to three (3) years.
