Application Your Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code CountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*Email* How did you hear about us?*Internet SearchPuppyfindFriendAKC MarketplaceHow many people live in your home?*Are you prepared for the commitment of a new family member and the time/costs associated?*YesNot YetWe have questionsWhat are you currently looking for?*Puppy (8-16 weeks)Older Puppy (16 weeks - 18 months)AdultOpenDo ANY family members have allergies to dogs?*YesNoUnknownIf your family circumstances change (New home, new job, new baby, divorce, etc.), what will happen to the dog?*Do you currently have any other pets?*What is your living situation?*House (Owned)House (Rented)Condo/AptTownhouseDo you have a fenced in yard?*YesNoDo you have a swimming pool?*YesNoWhat made you decide on an AmStaff?*Are you aware of the health problems that can be associated with this breed? What health concerns do you have?*Do you have a preference on gender?*Yes - MaleYes - FemaleNo preferenceAre you set on any specific colors or against any colors? Please describe.*Amstaffs come in Black, Red, Brindle, Fawn, Blue, Blue Brindle, Blue Fawn, Tricolor and White. Each of this comes in a wide variety of patternsWhat is the primary reason you are looking for a dog?*Showing /BreedingFamily CompanionDog SportsHow do you plan to socialize your puppy?*Are you a first time dog owner?*YesNoIf not, please give a short explanation of your experiences with your previous or current dogs*Do you have AmStaff breed experience and/or have you done research on the breed and their care and training requirements?*YesNoNot YetWhere will your dog spend the majority of the day?*If you work, how long will the puppy be left alone during the day? Have you made arrangements for mid day potty breaks and training? Please explain*Will you crate train your puppy?*YesNoAre you and your whole family prepared to take your puppy to training classes?*YesNoUnknownWill you Spay/Neuter your puppy?*YesNoDont know yetDo you plan to breed dogs?*YesNoUndecidedWhat is your time frame in buying a puppy?*ASAP/ImmediatelyWithin a couple monthsWithin the yearWilling to wait for the perfect matchFlexiblePlease rank in importance to your family 1. Looks, 2. Gender, 3. Color, 4. Temperament, 5. Show Potential, 6. Sport Dog Drive, 7. Therapy Pet Needs*How do you plan to receive your puppy?*Pick up in personShipped via airlineGround TransportUnknown at this timePlease list any references we should have for consideration (such as Veterinarian, pet sitter, dog walker, groomer, friends, other breeders, etc.)*Please list any further questions or concerns.*CommentsThis field is for validation purposes and should be left unchanged.