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Your Name*
Your Email Address*
Your Phone Number*
Your Address
Your City/Town
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How long have you lived at this address?
Other than Dogs, what other animals do you have?
What reference materials have you read?
How many individuals of this breed have ben aquainted with?
Landlords Name
Landlords Phone No#
Veterinarians Name
Veterinarians Address
Veterinarians Phone Number:
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?
How many hours on the average will the puppy be left alone?
Do you have any children? If yes, what are their ages.
If yes, to what and how severe?
At what age do you wish to get the puppy?
What kind of floor surfaces will the dog be on in the house?
How did you hear about this breed?
How many hours a day will the puppy be kept outside?
How will he be confined when he is outside?
If yes, at what age will you start?
Which activities or competitions are you interested in?
Who is the Trainer?
How long did your last pet live? What were the circumstances of its' death?
Have you ever returned a pet to the breeder? If so, what were the circumstances?
Have you ever given a pet away? If so, what were the circumstances?
Have you ever taken a pet to a pound or shelter? If so, what were the circumstances?
Please use this area to add any additional comments you would like to make
This completes the questionnaire. Please press the "Submit Form" button only once. The form will be sent to us for review. Once we have reviewed the form, we will contact you by telephone.