Thank you for your interest in an Agape Border Terrier or Dalmatian. By filling out this
questionnaire as completely as possible, you will help us select the right dog
for you. Please note that this form is not a reservation or guarantee of a
puppy or dog. Agape Kennels reserves the right to make the final
decision on the sale or transfer of puppies and dogs.

Full Name:


Street Address:


City, State, Zip:


Phone
Home/Work:


Email Address:


Which Breed Are You Interested In:
Dalmatian
Border Terrier

How Did You Get Interested In Dalmatians or Border Terriers:


How Did You Hear Of Agape Kennels:
Shows
Breeder
Ad
Web
Other

What Age Dog Are You Interested In:
Puppy
Adult
Any

What Sex Dog Are You Interested In:
Male
Female
Any

What Color Dog Are You Interested In:
Black
Liver
Any

What Activites Will Your Dog Be Involved In:
Pet
Conformation
Obedience
Performance
Breeding

Have You Ever Owned A Dog:
Yes
No

Do You Have Other Dogs Now:
Yes
No

If Yes, What Breed(s):


What Enviroment Will Your Dog Live In:
Inside
Outside
Both

How Will You Exercise Your Dog:


Describe Your Facilities For Housing A Dog (fence, yard, shade, dog door, ect...):


How Long, On Average, Will The Dog Be Alone During The Work Day:
1-2
2-4
4-6
6-8
More Than 8

How Old Are Any Children Who Will Be in Contact With The Dog:


Do You Own Or Rent Your Home:
Own
Rent

Does Anyone In The Home Have Allergies:
Yes
No

Please Add Any Questions Or Comments: