Name:________________________________________________________________
Address:______________________________________________________________
City:_____________________ State:___________________ Zip___________________
Phone Number (Home):_____________________ (Work)________________________
Name of your Veterinarian ___________________ His telephone number __________________
List names and telephone numbers of at least 2 friends we can call to verify information / suitability: 1) ___________________ Tele._______________
2)______________________ Tele. _______________
Good time to call if we need to reach you:______________________________________
How were you referred to us?:______________________________________________
Are you interested in puppy( ) Older trained dog( ) Information only( )
Male( ) Female( )
Structure/Size preference (circle) Large Standard Small None
Why are you interested in obtaining one of our dogs?___________________________________
Companion/pet ( ) Breeding ( ) Obedience ( ) Protection ( ) Herding ( ) Schutzhund ( ) other ( )
What qualities do you expect in this breed?___________________________________________
What qualities don't you want in this breed?___________________________________________
Is this your first time with this breed?________________________________________________
Why do you want to own this breed?________________________________________________
Previously owned dogs (Breeds) ___________________________________________________
Animals present at home now_______________________________________________
Have you examined our Sales Policy and Contracts?________
Are you committed to caring for this dog for its lifetime?__________
Are you willing to spay/neuter this dog?__________ if not, why not?__________________
If you are considering breeding, do you promise to (OFA) this dog prior to breeding it? ____
Can you contact our kennels prior to breeding ________
FAMILY DATA:
Are you: M S D (circle)
Your age_____ # of children______ Ages: ___________________________________
Others in household who will have contact with dog______________________________
Who will be responsible for this puppy?_______________________________________
Where will dog stay during the day?__________________________________________
Where will dog stay during the night?_________________________________________
Do you live in: (circle) Urban Suburban Rural (circle)
Do you own or rent your home? or Apt?______________________________________
Is the puppy/dog's area fenced? _______
Have you read information about puppy/dog care?_______________________________
Do you have all the equipment and a proper crate for this puppy?____________________
Have you checked into any breed/training clubs in your area?_______________________
Additional information that may help us make our decision:
Canine Specialties reserves the right to refuse any homes not deemed suitable for our puppies. We would like to Thank you for taking a moment to fill out this questionnaire. Please return this promptly. Again Thank you and hope to hear from you soon!
Sincerely,
Bob Armstead
Canine Specialties
