Here you will find our Puppy Application that must be filled out and approved to adopt one of our little beauties. Please contact us at our email or call us at 757-846-5918 to receive yours to start the journey of new puppy parenthood.


Puppy Purchase Application Form

The following questions are designed to ensure you and your puppy are well suited to spend many happy years together as devoted companions.  I want each and every puppy that I raise to go to a stable home where he/she will receive the level of love and care that he/she deserves, and I want you to be completely happy with your new baby!  Each and every prospective puppy buyer is asked to fill out this application with honesty and openness and to return this questionnaire to me.  Please note that filling out this application does not guarantee approval for a puppy. This application will help me determine if a Chihuahua is the best puppy for you and it will also help me learn something about where my Chihuahua puppy might be going to live.  Keeping this in mind, please complete and submit this Puppy Application. Please complete this ENTIRE form. Missing information and  incomplete applications will not be considered. If you cannot complete the application or have questions, please feel free to contact me.  I reserve the right to refuse to sell to any person for any reason, if I feel it is not in the best interest of my Chihuahua puppies for whatever reasons!  I WILL SELL TO FOREVER LOVING APPROVED HOMES ONLY!

 Please provide me with any preferences for male/female, particular colors you prefer, coat length, long coat, short coat or any other specifics, I want your Chihuahua baby to be your perfect puppy!  Please answer these questions honestly, then fill out the second page of information and email or fax it back to us!

Full Name:___________________________________________


Street Address:_______________________________


Zip Code:_______________

Daytime Phone/Cell Phone:___________

Evening: ____________

E-mail address___________________________

Best hours/days to contact you: __non-particular__________________________

How did you hear about us:  Facebook ___

Web Page ___ Friend/Referral____

Occupation: ___________________

Are you interested in: Puppy______

Older Dog_______?

Are you interested in a : _______ Male    ________ Female    ________

No Preference____________

Do you have a color preference: _______________________

Do you have a size preference:(most of our puppies are around 3 to 7 lbs)

______ Under 4 lbs

______ Over 4 lbs

__    ___ Does not matter

Chihuahuas range in size from 2-7 lbs mature.

How long are you willing to wait for a Chihuahua to become available? ___________________

What is your primary reason(s) for wanting a Chihuahua?

(check as many as appropriate)

_____ Breeding

_____ Show (Conformation)

_____ Pet/Forever Companion

_____ Other (describe below)

Are you considering requesting full CKC/AKC rights for breeding the Chihuahua that you purchase from us? ___Yes (not sure)____

If yes, please explain so we may know more about you and your breeding program, such as, Do you have a Website? No, Kennel Name? No, How long have you been breeding or thinking about breeding and why?______________________________________________

Have you ever owned a Chihuahua before, if this will be your first Chihuahua have your researched the breed and its characteristics? _______

I/We are interested in a Chihuahua because _______________________

Are you familiar with the possible health issues related to Chihuahuas? Are you familiar with hypoglycemia and what to do in the case of an emergency? ______________________

Does your lifestyle give you the time and energy to properly care for and exercise your Chihuahua?_______________________­­­_____________________

Where will the Chihuahua sleep at night? (Chihuahua’s do not have the coat to tolerate inclement weather – they need and want to be a member of the family.) ______________________________________________

Who will be primarily responsible for your puppies care? ____________________________________

Number of Hours worked outside of home per week? ____________________________________

Whom, if anyone is home during the day? If no one, how long will your puppy be left home alone? ______________________________________________

Are you familiar with crate training and where will your puppy be kept when you are not home? ______________________________________________

Chihuahuas are strictly indoor dogs and need to be kept inside when unattended or you are away from home. They should never be left outside unattended due to their size, danger from all types of prey, and their intolerance to heat and/or cold.  Please acknowledge that you are aware of this when signing this application.

Please list all adult members of your household, including yourself, their names, ages and relationship to the  applicant. (Please include all residents whether related or  unrelated ______________________________________________

Do children live in your home? Yes ___ No___

If so please list all children in your household and their ages.  Please include children that may be in your home part time only. If none, please state.__________________________________________

If you have children, are you willing to take on the added tasks of training and exercising a Chihuahua?  ______________________________________________

Are all family members enthusiastic and agreeable to owning a Chihuahua and have you discussed the merits and requirements of the breed? ______________________________________________

Does anyone in the household have allergies? ______________________________________________

Have you considered the financial cost of dog ownership; are you financially prepared to give your new puppy the medical care, quality food, training, etc. for its lifetime? _______________________

What is your training experience, or method?  (Chihuahua's respond to positive gentle training; they will not respond well to heavy handed training methods.)

The longer you work with them, the more you will be convinced that they can understand the human language I have had dogs most of my adult life; ______________________________________________

Do you have any other pets currently in your home either full or part time? If so, please list their ages and type of breed ____________________________________________________________________________________________

Have your current pets been spayed/neutered? Please provide documentation from vet.____________________________________________

Have you owned any pets in the past pets that are no longer with you? ______

If yes, where are those dogs now or what happened to them.___________________________________________

Do you understand all of our pets (puppy/adult) unless for show/breeding are sold on limited AKC under spay/neuter contracts? _____________________________

Do you own or rent your home? _______________________

If you rent/lease, please provide your rent/lease agreement which states the type of pets you are allowed to own and that owning a pet is approved or permitted. Also please provide the name, address and phone number of your landlord so we can verify that your puppy is allowed.  Be sure to inquire with your landlord about size, gender, or other restrictions.


Type of house: Urban___­­­­__ Suburban___ Rural______

Do you have a secure, fenced yard? ___________

Do you have a pool? _____

 If yes is your pool fenced? _______

Do you currently have a Veterinarian? Please provide the name and address of the Veterinarian you will be using for your new puppy. If you would like suggestions for choosing a Veterinarian for your new puppy please let me know. Please be advised that I will be contacting your Veterinarian for a personal reference. ____________________________________________________________________________________________


If you have any other questions or concerns you think would help select the right dog for you as they will become an integral part of your life and family please free to contact us and we will be happy to help.  Please provide any additional information that you would like us to consider as we review your application. If you are interested in a specific Charlotte's Web puppy, please give that puppy's name here, or describe which puppy you are interested in. _______________________

I represent that the information that I have provided on this form is the truth to the best of my knowledge and belief and hereby give my permission for you to use any of the above information to confirm that all information provided is the truth.  This mean you give us permission to call references and that you allow us to contact your vet and that you hereby give consent for your vet to release the information in your current/past pet's health information to us.

If you are approved please let us know if you see a puppy you are interested in or you can choose to go on our waiting list.

Thank you very much for your interest in one of our beautiful Chihuahua puppies. We will contact you as soon as possible.


Date: _______________________

 *************end of puppy application**************


Please look over our Contract and let us know if you have any questions or concerns. Many of your questions may be answered here.

PUPPY CONTRACT : for Charlottes Web Of Chihuahua's

New Owners Information:

Full Name:___________________________________________

Full Address:_________________________________________________________________

Cell Phone/Home:_________________


Puppy’s Information Name: _______________________

D.O.B: _____________  Sex:  M_____ or F______

Color: _______________________

Sire: _______________________

Dam: _______________________

Registration:   (Circle)    CKC    or     AKC (Limited or Full)

Puppy is being in placed in a:  Show/Breeding____

Pet Home______

A deposit of $_________ has been placed on this day ______________.

The amount of $___________ is due when the puppy is 8 weeks old which will be

on the date ____/______/______.

Deposits and any other money paid in on a puppy are NON-REFUNDABLE and NON-TRANSFERABLE.  If the puppy were to pass away while under our care, puppy will be replaced with another puppy of EQUAL VALUE. During the waiting period, if the puppy becomes sick, or I feel like this puppy isn’t suitable to go to a new home, Buyer will have to choose another puppy or wait for upcoming litters.  During the waiting period of waiting after you have placed a deposit on a puppy, if I feel like you are not suitable for one of my puppies, I do have the rights to refuse to sell you a puppy.  Your deposit will be sent back to you within 90 days.

_____ I do not guarantee size, color, disposition, show quality or breeding ability. Our guarantee does not include poisoning, accidents, negligence or behavioral problems, as training philosophies and environments vary amongst individuals.

______ Breeder (Brenda Burch Freeman of Charlotte’s Web of Chihuahuas) confirms that the puppy is healthy at the time of pick up or delivery.  Breeder has provided the puppy with all age appropriate shots, deworming, vet checked, and will provide Buyer with records and other necessary paperwork such as registration papers.  Buyer must have puppy examined by a licensed/reputable Veterinarian within

48 hours of pick up.  The exam must include a fecal test.  If this is not done in a timely manner, the puppy’s health guarantee is VOIDED.

The buyer will be responsible for this examination and for any other charges incurred from this examination.  If the puppy dies within the 48 hour period the Buyer must have an Autopsy done.  The puppy is guaranteed to be free from hepatitis, parvovirus, distemper and canine influenza, within the 48 hour period.  Puppy is also guaranteed to be free from any major genetic defects of the organs for 1 year from birth.  If the puppy is found to have one of these sicknesses or defects, Buyer must contact Breeder the same day.  Buyer must have signed paperwork from the vet with its findings.  Buyer will have 3 days to return puppy with all paperwork including registration papers.  Breeder may require a second opinion from their vet.  If the puppy is still diagnosed with the same sickness, the puppy will be replaced with another puppy of equal value.  Replacements can take up to 12 months.

Breeder does not guarantee/warrant the puppy against common   giardia, internal and external parasites, hernias (inguinal or umbilical), mild luxating patella’s (grades 1-2), cherry eye, heart murmurs, or allergies.  This guarantee does not cover open fontanel, skin allergies, uneven bites, undescended testicles, mange, seizures associated with hypoglycemia or injuries/death from neglect.  The Buyer understands that internal parasites (including hookworms, roundworms, whip worms, coccidian and giardia) are considered a normal occurrence of all puppies and that their puppy will need fecal exams and deworming up to 16 weeks of age or more.

I DO NOT cover Hypoglycemia (low blood sugar).  It is your responsibility to make sure your puppy is eating and drinking on a regular basis.  Please see attached page for more information.

If a major problem has been determined and return of puppy is desired and agreed upon by both parties, a replacement puppy of comparable size, color, gender and value will be given to the buyer as long as all terms of this contract have been followed.  Under no circumstances will a cash refund be given.  Any veterinarian expenses incurred determining problem/health status of this puppy will be the sole responsibility of the buyer and no refunds or reimbursements will be expected from seller.  If the puppy is returned to seller shipping is the sole responsibility of the buyer and no reimbursement will be expected from the seller.  Shipping will also be paid for by the buyer for the replacement puppy.


If the puppy is being sold as a pet, the puppy will come with limited registration papers.  Buyer agrees to SPAY/NEUTER the puppy before the age of 7 months for males and 10 months for females unless otherwise stated.  Breeder will hold papers until proof of spay.  The puppy is being sold to a pet home because it is either not suitable for breeding and the puppy can suffer if it is bred (size or health wise) or the puppy may not be of breed standard (pet quality), or I may strictly want the puppy not to be bred because of its bloodlines.


_____ Buyer promises that if at any time in this dog’s life, you find you cannot care for or do not wish to care for this dog anymore, this dog will not be taken to a shelter or given to another party.  Buyer will take the puppy back for a rehoming fee of half of the original purchase price BUT if the breeder cannot take the puppy back at the moment, Breeder will allow buyers to rehome the puppy to another responsible PET HOME.  This health guarantee will only go for the first owner of the puppy.  There will be no 3rd party placement of full AKC. Puppy must go to a PET HOME ONLY.  Buyer promises to pay/neuter puppy before it leaves their care, the new home must be approved by the Breeder and the Buyer must provide Breeder with all the new owner information.  Registration papers must be sent back to the Breeder.  This is to protect the puppy/dog and make sure he/she is not going into any other Breeder homes or puppy mills.  If the Buyer sells the puppy to a 3rd party with  Full AKC rights, brings the puppy to a shelter, does not spay/neuter the puppy before rehoming it, rehomes puppy without Breeder’s approval, or doesn’t provide Breeder with the puppy’s whereabouts, Buyer will owe the Breeder a penalty/fine of the amount paid for that puppy (original purchase price from Breeder).  Breeder also has the right to seize the puppy if there is proof of abuse/neglect.

If a deposit has been made on a puppy to hold that puppy until old enough to leave its mother or for another reason agreed upon by seller and buyer, the buyer will make arrangements to pick up the puppy between 8 and 12 weeks (to be determined by individual puppy) or boarding charges will be added to the total of the bill at a cost of $5.00 per day and any other charges incurred for the puppy (vaccinations, veterinary care, deworming, etc.) will be charged to the buyers bill and will need to be paid in full before the puppy can be picked up by the buyer.  If the puppy is not picked up within two weeks of the agreed upon date and time, seller has the right to sell the puppy to another party and buyer forfeits all rights to the puppy.  If the puppy is to be shipped, buyer agrees to have the balance of the puppy, the deposit, as well as shipping, paid in full by the time the puppy reaches eight weeks of age.  If the balance is not received and no other payment arrangements were made in advance, buyer forfeits any payments made on the puppy and seller has the right to sell the puppy to another buyer.  If the puppy dies or becomes unfit for sale before the puppy is ready to be picked up, a refund will be granted as stated above.

When registering puppies, Charlotte’s Web has to be included in the puppies registered name.  If you fail to do so, this contract will be submitted to AKC and the name corrected.

This contract represents Full and Final guarantees, agreements, and terms of the sale of this puppy between Seller and Buyer.