Application Request for a Youngs Chihuahua

Youngs Chihuahua Request Form

If you are interested in a Youngs Chihuahua,
please complete the request form below.
Be sure to answer all questions; we will not respond to incomplete applications.

Application For (check all appropriate):

Puppy Other adult
(If you are interested in a specific dog or puppy you saw on our web site, you can provide that information at the end of this application.)

Male Female No Preference

Your Name:

Address:

City:

       Zip/Postal Code:

E-mail address:

Your veterinarian's name, address, phone number (and email address if available):

Have you owned any dogs before? Yes        No

If yes, where are those dogs now or what happened to them:

Have you owned a Chihuahua before? Yes        No

Do children live in your home? Yes        No

If yes, how many and what are their ages:

Do you own or rent your home? Own        Rent

Describe your home (house, apartment, farm, other--be specific):

Do you have a fenced yard? Yes        No

Are there other pets already living in your home? Yes        No

If yes, please describe them:

What is / are your primary reason(s) for wanting this Chihuahua (check as many as appropriate):
Watchdog
Breeding
Show (conformation)
Obedience
Agility
Pet / companion
Other (describe below)

Please provide any additional information that you would like us to consider as we review your application. If you are interested in a specific Youngs Chihuahua puppy or adult, give that dog's name here, or describe which puppy / where on our web site you found the puppy's picture.

Before you click "Send," make sure you have answered all questions. Incomplete applications will be discarded without further consideration.

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