We want our pups and our puppy buyers to be happy together! A thorough screening will help us determine the best fit for you & your new Bella Rosa puppy. Please provide the following information to the best of your ability:

First Name
Last Name
Company
Street Address
Address (cont.)
City
State
Zip/Postal Code
Country
Work Phone
Home Phone
Cell
FAX
E-mail
URL
	Names, ages and relationships of all persons in the home: Adults:   Children:   Do you currently have any other pets? Yes or no     If you answered "yes" to the above question, please list and describe your pet(s) as follows: Name, Type, Age, Sex, Spayed/Neutered:   Current veterinarian information: Name:   Address:   Phone:   Current residence information: Do you own or rent your home: Type: Detached single-family home, Townhouse/Duet/Duplex, Apartment/Condominium Yard: (Fenced Yard, Unfenced Yard, Patio/Deck Only, No Yard) Please describe the approximate size of your yard and the type of fencing:     Will the dog live primarily inside or outside?   When the dog is outside, please describe the shelter it will have:   Will there be anyone home regularly during the day?   If you answered "yes" above, approximately how many hours per day?   Have you ever owned a dog?   Please describe the type of dogs, when you owned them and if you no longer have them, what happened to them?   Please describe your experience with dominant dogs:     How often will you work / train your dog?     Are you interested in showing your corso?     Are you a member of, or do you participate in, any animal-related groups, such as animal rescue, etc?     Why do you want a Bella Rosa Cane Corso?   What type of canine training experience do you have? Puppy kindergarten, Obedience training, CGC, TDI, TT, Advanced ( SchH, PP, etc.)   Do you have a trainer that you currently use or have used in the past?   What activities will you and your corso be involved in? Agility, Conformation, Obedience, Puppy Kindergarten, Schutzhund, Personal Protection, Therapy Work, Tracking, Weight Pulling   Do you prefer a male or female?   Do you have a color preference? (Please note that color should be secondary to overall health, conformation and, most importantly, temperament!)       Please supply names and telephone numbers of at least 3 personal references. These should be people who are familiar with your care and treatment of animals:   What else would you like us to know about you?   Please type your full name here. By doing so, you are giving us your e-signature that the above information is true and correct to the best of your knowledge. By providing your e-signature, you are also authorizing us to contact any individual listed above and to obtain information about you that could be regarded as confidential. We reserve the right to approve or deny any application at our discretion. Note: This is not a sales contract. Submission of this application in no way implies that we are bound by any terms to sell you a puppy.