Name: 

Street Address: 

City:

State:

Zip Code:

Country:

Home Phone Number: 

E-Mail Address:

Name and relationship of all adults in the household and those who visit often (please specify each as a resident of the household or a frequent visitor):

Age and sex of all children who live in the household and those who visit often (please specify each as a resident of the household or a frequent visitor):

Do you own other animals?   yes    no   

If yes, please give the following information about each animal:     

species: breed: sex: age: spayed/neutered?

Do you own or rent your residence? own    rent    other

Do you live in a single family house townhouse condo apartment other?

How long have you lived at your present address?

Do you have a fenced yard?    yes    no     

If yes, please describe your fence (type and height):

Please describe your property including approximate house and property size (acres or dimensions):

Do all family members work outside the home?    yes    no

How many hours per day will the puppy/dog be alone?

Have you ever owned a dog before?    yes    no

If yes, what breed(s)?  

Have you ever surrendered an animal to a shelter, given an animal away or sold an animal?    yes    no

If so, please describe the circumstances:

Have you ever owned a Cane Corso?    yes    no

If yes, who did you get your previous Cane Corso(s) from?

Are you interested in:    Pet Quality    Show Potential   

What sex are you interested in?    Male    Female    Flexible    Undecided

Do you have a color preference and if so, what is your preference?

Are you flexible in regard to color? yes, I'm flexible    no, I am only interested in the above color(s)

What age range are you interested in?

What kind of temperament are you looking for?

What are your goals? (Check all that apply)    Family Pet    Conformation Dog Shows   Breeding   

General Protection of the Family    Sport of Personal Protection    Schutzhund    Obedience   

Agility    Weight Pulling

Other

If you have ever earned any titles with other dogs, please list:

Would you be willing to attend a puppy kindergarten class and a basic obedience course in a class setting with a certified trainer? yes    no

Would you be able to pick up a puppy personally from Maryland?  yes  no  

Will the puppy/dog spend most of its time: inside outside?

If the puppy/dog will be spending time outside, please describe its shelter:

Do you plan to crate train?    yes    no    undecided

Your veterinarian's information for your most recent pet(s):vet's name: Clinic or Hospital Name: Address: Phone Number:

Personal Reference that is familiar with you and your animals:Name: Address: Phone Number:

Puppies need to be trained.  They will not automatically know how you want them to behave.  Do you realize this and are you willing to be persistent and work through behavioral problems?    yes    no

How did you hear about Apex Cane Corso Italiano? 

Referred by:   Met at a Show/Event:: 

Found Apex website on the Internet from the following search or website link:

Dog Fancy  Dog World  Dogs USA  Other:

What is the timeframe of when you want to bring a puppy/dog home?

How serious are you?

Please give any other information that you feel is important:

Intentional falsification will result in application denial and loss of deposit.  We reserve the right to verify all information which could include a visit to your home by Apex or a representative of Apex.  Please be honest.  There are no wrong answers.  We just want to match the right dog to the right home.  By submitting this application, you are certifying that all of your answers are true and that you have read and understand the information on our policies page.  Do you understand and agree to this?      yes    no

Please e-mail your ANSWERS ONLY (DO NOT USE THE FORM as it will not transmit)

to Apexcanecorso@aol.com

Please contact us to make sure that we received your application 443-987-5154