CONTACT INFORMATION
Your Name:
Your Address:
City / State:
Zip code:
Country:
Home Phone:
Cell Phone:
Email Address:
How many children and adults live in your household?.
Children:
Adults:

OTHER PETS
Do you currently have other pets?
(If yes, please list and describe your pet(s), Names, type, age, spayed/neutered)

RESIDENCE INFORMATION
Own or Rent?
Type of Residence?	Single Family      Multi Family       Condo/Town House
Do you have a Yard?
Size of Yard?
Is Yard Fenced?	Yes      No
If Yes, describe (height/type)

SCHEDULE INFORMATION
How many hours per day will the puppy/dog be alone?
Can regular exercise be given on a daily basis?	Yes      No

PAST DOG EXPERIENCE
Have you ever owned a large breed dog in the past?	Yes      No
If yes, what breed?
Are you interested in Pet Quality or Show/Breed Quality?
Do you have a sex preference?	Male      Female     No Preference
Do you have a color preference?
Are you flexible with your color preference?	Yes      No
What are your goals with this dog?	Family pet      Conformation shows    Obedience    Agility Weight Pulling    Other
Do you plan to enroll in basic obedience classes with certified trainers?
Do you plan to crate train?	Yes      No

Signature:
Date: