| Puppy Questionnaire / ApplicationPlease e-mail your completed questionnaire to crosscreekbrittanys@gmail.com,
or call us with any questions: 812-941-1716 
 CONTACT INFORMATION
 Name:
 Address:
 City:
 State:
 Zip:
 Home Phone:
 Cell Phone:
 E-mail:
 
 Please tell us a little about your home, family, current pets, past dogs (especially Brittanys, if any).
 
 What are you looking for in a Brittany?
 
 Do you have a specific timeline in which you'd like to get a Brittany, or are you willing to wait for the right one?
 
 Are you looking for a male or female, or open to either?
 
 What age range are you willing to consider?
 
 Do you plan to spay/neuter this dog?
 
 Where do you plan to keep this dog at night, and/or when you're not at home?
 
 Are you interested in possibly competing in shows, field trials, or other events?
 
 Any additional comments or questions:
 
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