Epiphany Puppy Form
Name or names
Street Address
City/State /Zip Code
Phone Number
Email
Do you have children
Yes
No
If you have children, how old are they?
Do you own or rent?
Own
Rent
Other
If other, explain
Do you have a fenced in yard
Yes
No
If you do not have a fence, can you put one up?
Yes
No
Can't
What color do you prefer?
What sex?
Male
Female
Either
If you want a bitch are you willing to whelp a litter?
YES
NO
Are you interested in showing?
Yes
No
Maybe
I have not thought about this
Do you have any other pets?
Have you ever owned a Bull Terrier? Where did you get it? What Happened to it?
Are you willing to drive to Pittsburgh to pick up your puppy?
Yes
No
Comments and Questions