Puppy Questionnaire Web Site Your Details Let us know how to get back to you. Name * Address * City * State * - Select Province/State - Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ==================== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip * Phone * Secondary Phone Email Address * Referred By How many individuals of this breed are you acquainted with? * What reference materials have you read? * Type of dwelling * House Condo Apartment Mobile Home If renting, please give name, address, and contact information of landlord Name, address, and contact information for your veterinarian * Who will be the primary care giver? * Where will the puppy be kept during the night? * Where will the puppy be kept during the day? * Is anyone home during the day? * How many hours on average will the puppy be left alone? * Will there be someone available to feed and exercise the puppy during the day? * Have you ever owned a dog before? * Do you have any other animals? * Do you have any children? If yes, what are their ages? * Does anyone in your household have allergies to animals? * If yes, to what and how severe? Are you most interested in a male or a female puppy? * Male Female At what age do you wish to get the puppy? * Have you considered an older dog instead of a puppy? * Yes No How did you hear about this breed? * What do you expect the activity level of his breed to be? * High Moderate Below Average What kind of floor surfaces will the dog be on in the house? * How many hours a day will the puppy be kept outside? * How will he be confined when outside? * Do you have a fenced yard or suitable pen? * Yes No Have you ever house trained a dog before? * Yes No How long have you lived at this address? * Will you be attending any training classes? * Yes No If yes, at what age will you start? Who will the trainer be? Which activities or competitions are you interested in? * Have you ever returned a pet to the breeder? * Yes No If so, why? Have you ever given a pet away? * Yes No If so, why? Have you ever taken a pet to the pound or shelter? * Yes No If so, why? Are you interested in showing the dog in the conformation ring? * Yes No Have you ever shown a dog to a championship? * Yes No Have you ever shown a dog to any performance titles? * Yes No Do you intend to breed the dog? * Yes No Do you understand the difference between a limited registration and a full registration? * Yes No