Your full legal name     

Your Occupation           Married Single Widowed

Full legal name of spouse/significant other 

Occupation of spouse/significant other  

Does your spouse/significant other know of, and approve of owning a PWD?   Yes   No

Your home address 

City     State     Zip Code  Country

Your E-mail address 

Home Phone     Best time to call     

Do you Rent?    or  Own your home?   

What is your Landlord's Name?    Phone # 

Do you have any restrictions on the number of pets you can own?    Yes   No     If so, how many?

Do you have a fenced yard?    Yes   No      If Yes, please describe the size of the yard as well as the fence:

If it is not fenced, do you plan to fence?  Yes   No    If Yes, please tell us your plans in the space below:

Do you have children living at home?  Yes No     If yes, please tell us their ages:

Child #1:  Age       Child # 2:  Age       Child # 3:  Age       Child # 4:  Age       Child # 5:  Age 

Do your children like animals?  Yes No     Please use the space below to tell us how your children interact with dogs, please be specific.  Feel free to include any funny stories about your child and a dog.

Does anyone in your household have fears of any kind, concerning animals?  Please be specific.

Have you ever owned any dogs, including PWDs?   Yes No     If Yes, please tell us about your dog(s), (breed/sex).  If you no longer have the dog(s), please tell us why you no longer have it/them:

Please tell us about the pets you currently have:

Type   Breed    Sex    Age  Spayed/Neutered?  Yes No

Type   Breed    Sex    Age  Spayed/Neutered?  Yes No

Type   Breed    Sex    Age  Spayed/Neutered?  Yes No

Type   Breed    Sex    Age  Spayed/Neutered?  Yes No

Type   Breed    Sex    Age  Spayed/Neutered?  Yes No

If you obtain a PWD, where will he/she stay during the day? 

Where will he/she stay at night? 

Do you object to spaying or neutering your PWD?     Yes No

Do you object to crate-training your PWD?    Yes No

Portuguese Water Dogs demand attention; they need grooming on a regular basis, and daily exercise.  Are you ready and able to commit time to your dog?     Yes No

Are you interested in:    Obedience?     Agility?      Water Works?      Just fun    (check as many as you like)

Please tell us about activities that you plan to enjoy with your PWD in the space below:

Would you prefer a:     male     female      either would be acceptable 

Would you prefer a:    wavy coat      curly coat     either would be acceptable 

Which coloration would you prefer?    Black      Black with white markings      White with black markings  

Are you interested in:     a young puppy (10 to 14 weeks)     an older puppy (4 to 12 months)  

Please tell us what characteristics would best suit you/your family, and check as many as you wish:

Would you be willing to accept a rescued dog, from the PWD Rescue Organization, who may have special medical needs, or may have been abused?    Yes No

How long are you willing to wait for a puppy?    6 months?      9 months?      More than 9 months?  

Do you have any questions about Portuguese Water Dogs? 

Would you be willing to stay in contact with us so that we are able to track the growth and development of our dogs?         Yes    No 

Often, people place themselves on several breeders' lists.  Are you on other breeders' lists?    Yes    No       If you are, that's fine.  If you receive a puppy from another breeder, please email us at baycliffpwds@hotmail.com so that other families can move up on our waiting list.

Please provide us with three references - family, friends, business associates, etc.  Please list one neighbor.

Reference 1:     Name      Relationship 

Street Address 

City     State     Zip Code 

Phone Number      Best time to call 

Reference 2:     Name      Relationship 

Street Address 

City     State     Zip Code 

Phone Number      Best time to call 

Reference 3:     Name      Relationship 

Street Address 

City     State     Zip Code 

Phone Number      Best time to call 

We are currently having difficulty with our application page.

Please go to the Navio Portuguese Water Dogs’ webpage

 to submit an application if you are interested in a puppy.

We thank you for your patience. 

Thank you for your time and patience in completing this form.

Baycliff reserves the right to refuse to place a puppy at any time, for any reason.