APPLICATION TO ACQUIRE PARSON RUSSELL TERRIER

Email completed application to: BVRanch@cox.net

Call 619-302-3460 for further information

Guardianship of another animal is a major responsibility and a long-term commitment. You

may share 10-20 years of your life with the Parson Russell Terrier ("PRT") that you acquire.

To get one of our special PRTs, you must be: (i) at least 18 years of age; and (ii) able and

willing to spend the time and money necessary to provide the proper day-to-day care, training,

and veterinary services for your PRT for its entire natural lifetime. If you wish to acquire one of

our PRTs, please complete and return this application to us.

HOW DID YOU LEARN ABOUT BLOSSOM VALLEY PARSON RUSSELL TERRIERS?

¨ AKC Breeder Litter Advertisement

¨ Breeders.Net Listing

¨ Online search

¨ Newspaper Advertisement in _______________________________________________

¨ Personal referral from _____________________________________________________

¨ AKC Conformation Dog Show contact with: ____________________________________

¨ Other: _________________________________________________________________

WHAT ARE YOU LOOKING FOR IN A PRT?

Sex desired: Male:__ Female:__ Either:__

Color desired: White:__ White/black markings:__ White/tan markings:__ Tri:__

Coat type desired: Smooth:__ Broken:__ Rough:__

Age(s) desired or acceptable: Puppy:__; 6-12 mos:__; 1 to 2 yrs old:__; adult:__

PERSONAL INFORMATION:

Please provide you name(s), address, phone numbers, and email address:

_________________________________________________________________________

Your Age: ___ Age of Spouse/Partner: ___ No & ages. of Children: _________________

How long have you lived at this address?_____________

May I visit your home to see the PRT and how you are taking care of it?____________

Do you own or rent your home? __________

Is it a (check one): ___ house ___ apartment ___ condo?

Do you have a fenced yard? No: __ Yes: __

If 'yes," what kind and size?

_________________________________________________________________________

Do you have a pool? No: __ Yes: __

If "yes," is it fenced? ____ If “yes,” what is the height and material of the fence?

_________________________________________________________________________

EMPLOYMENT INFORMATION:

Please provide your and your spouse/partner’s occupation, work address, work phone

number(s), and email address?

You:

_________________________________________________________________________

Your spouse/partner?

_________________________________________________________________________

How many hours are you and your spouse/partner away from home each day?

You: ________________; Your spouse/partner: ________________

EXPERIENCE WITH PRTS AND OTHER ANIMALS:

Have you ever had a PRT or other terrier before? Yes ____ No ____

List the pets that you and your spouse/partner have had in your lives and state what happened

to them:

_________________________________________________________________________

WHAT WILL YOU DO WITH YOUR PRT?

Are you willing to take your PRT to basic training classes? No: ___ Yes: ___

Activities: Conformation:___ Agility:___ Earthdog:___ Obedience:___ Rally:___

If you do not do conformation, are you willing to spay/neuter your PRT? No: ___ Yes: ___

Who will take primary care of and responsibility for the PRT?: _________________________

Who will be responsible for the PRT if something happens to you?

_________________________________________________________________________

Where will your PRT stay during the day?

_________________________________________________________________________

Where will your PRT sleep at night?

_________________________________________________________________________

If you go away for a few days, who will care for your PRT?

_________________________________________________________________________

What is the maximum that you are willing or able to spend on veterinary care? $ _________

PLEASE PROVIDE ONE VET AND THREE PERSONAL REFERENCES:

Name, address, and phone number of your veterinarian reference:

_________________________________________________________________________

Names, addresses, and phone numbers of three personal references who can vouch for your

humane treatment of animals and will know your whereabouts in the future:

Reference #1’s:

_________________________________________________________________________

Reference #2:

_________________________________________________________________________

Reference #3:

_________________________________________________________________________

AGREEMENT:

By typing or signing our name(s) below, I/we agree that:

--My/our typed name(s) constitute(s) an electronic signature for legal purposes if transmitted

electronically,

--The facts provided in this application are true and correct to the best of my/our knowledge,

--I/we realize that all such facts are material to the Breeder's decision to sell me/us a PRT,

--Any such fact that is not true will constitute legal misrepresentation in the formation of any

Contract of Sale ("Contract") that results from submission of this Application to Breeder,

--Any material misrepresentation is grounds for the Breeder to immediately rescind any such

Contract, and Breeder may repossess the dog that is the subject of the Contract and retain all

money paid for the dog, as liquidated damages for such misrepresentation, since damages are

difficult to determine, prove, and calculate.

Applicant's Signature: ______________________________________________________

Spouse/Partner's Signature: __________________________________________________

Date: ______________ City/State where signed: _________________________________

Additional Comments (if desired):

_________________________________________________________________________