| INSTRUCTIONS: Save this application to your
computer as a WORD Document before completing. When finished
completing, email the saved file as an attachment to:
wowlane@hughes.net.
|
Please fill out
the form completely. The form may be completed on your computer and
returned to the sender via e-mail, or a hard copy may be mailed to:
Bountiful Farm, Attention: Dan or Paula Lane, 33372 Calhoun Road, Shady Point, Oklahoma 74956,
bountiful@hughes.net
Farm Name:
Owner Name(s):
Address:
City:
State: Zip:
Home Phone:
Mobile Phone:
Work Phone:
email if sent by USPS:
_______________________________________________________
Best time to call: ______________________
Occupation:
How did you find us?
_________________________________________________________________________________
Personal reference (not a relative):
Relationship:
_______________________________________ Phone:
Own or Lease farm: ____________ How long have
you farmed/lived at this address? __________________________
If less than one year, give previous address:
Type and quantity of livestock to be guarded:
Number
of fenced acres: Fence type and height:
What is your terrain like? [i.e. hilly,
flat, steep, rugged, etc]___________________________________________________
What kinds of vegetation is there on your
farm/ [all trees, all grass, mostly small trees and shrubs]
____________________
What kind of shelter from harsh weather is
available to your livestock and LGD(s)?
Do
you currently have working LGD’s on your farm? If
so, list the breed, age, sex of each LGD and the type
of livestock each is guarding:
How long have you
owned LGDs?
_______________________________________________________________________
What types of predators are in your area?
Are
there provisions in place to safely introduce your new LGD to the livestock or
to provide a safe haven for your puppy?
________
Please describe:
Will your Bountiful puppy or dog live in a fenced
area with the livestock it is guarding?
Do
you provide monthly Heartworm prevention to your LGD’s? _______ Type of
Preventative used:
How many dogs have you owned in the last five
years? Do you still own the dog(s)?
_____________________
If not, what happened to the dog(s)? (Please
be specific):
Do you own other dogs, or cats, as pets? ______
Are they spayed/neutered? ______ How are they kept separate from your
working LGD(s)?
Do you have a regular veterinarian? ______ Name
of veterinarian:
Address:
Phone:
Do you want a (circle/underline):
Male Female No preference
FOR NEW LITTERS ONLY: A deposit of $300 (circle or underline)
enclosed by check sent separately through PayPal (click on www.bountifulfarm.com/contact.htm
and then click on the PayPal logo) is required to hold a specific puppy through
the age of 16 weeks.
Your signature on this application attests that
the information you have given is accurate and true and also gives your current
and past veterinarian permission to provide any and all information requested by
us in regard to the medical and preventative care provided to any current
and past livestock, or pet(s) of yours that they have on record. email delivery
shall be considered to have a signature.
_______________________________________________________________
Signature Date
