First State Coton
Delaware’s first
Coton de Tuléar breeder
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Phone number: 610.368.4968


Please tell us a little bit about who you are, what you are looking for, what experience you have in owning a dog, what environment the dog will live in, and about any medical issues that might affect your household or dog.

Who are you? 
Street Address:
Phone number:
Email Address:
City, State, and Postal Code:

What are you looking for?
Where did you hear about the Coton de Tulear:
What made you interested in owning a Coton de Tulear?:
Do you prefer a male or a female and why?:
What determined the age of the dog you are looking for?:
What is the most important reason for purchasing a puppy at this time?:

Ownership Experience 
What kinds of dogs have you owned in the past?

Who's dog was it?  My DogFamily Dog
How old were you if a family dog?
Do you currently own any other pets? If so:  
What are the ages of these pets?
Have they always lived with you?  YesNo
Are these other pets neutered?   YesNo
What sex are these pets?
When you first bring your new Coton home how much time do you think it will need to adjust?:
Do all members in your family want this dog?  YesNo
Is everyone willing to help take care of this dog? YesNo
Please describe your family to me:  
 Number of people
 Ages of children
Is there usually someone home during the day?  YesNo
Are you familiar with house breaking puppies?   YesNo
 If so, how do you plan to housebreak this puppy?  
Have you completed any CKC/AKC/UKC titles on other dogs?   YesNo
 Are you willing to attend classes with you dog, like puppy classes or other classes to help socialize your new pet?  YesNo
Do you know how much grooming a Coton requires?  YesNo
 Are you financially prepared for not only the cost of a puppy, but veterinarian costs, to feed your pet quality food, classes, emergency surgeries, etc.? YesNo
Have you ever bred dogs before? If so, please explain.  
If you have bought other show puppies please list from which breeder they were purchased and could these breeders be used as a reference?  
If this is a show puppy will you be showing the dog yourself or hiring someone to show for you?
 MyselfHiringNot showing

Home Environment
 Do you live in a house, condo, or apartment?  Note: if you rent a letter from your landlord will be required stating the dog will be allowed in your home. HouseCondoApartment
Is your yard completely fenced with secure fencing?  YesNo
 If so, what type of fence is it (physical or a wired or wireless pet containment system)?  
If not, would you be willing to do so prior to bringing the puppy home?  YesNo
Where will you be housing the puppy?  Dog runIn the houseCrate
 If you plan to crate the dog, where will the crate be located on your property?  
Where will the puppy be kept while you are away from home?
Where will the puppy be sleeping at night?
If you crate the dog at night, where will the crate be kept on your property?:
Do you have a secure place to let the puppy/dog run? YesNo

Medical Issues
How much exercise do you plan on this dog needing?:
Are there smokers in the family household?  YesNo
If this puppy is purchased for any reason other than a show/breed prospect, do you agree to have it spayed or neutered no early than 1 year of age and submit to me a veterinarian certificate as proof of surgery for my records?  YesNo
Name, address, and telephone number of your veterinarian:

Name, address, and telephone number of a close personal reference as an emergency contact:  
What questions, if any, do you have for me?

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