my business copyright 2000 no animals were harmed in the making

Puppy Questionnaire

All potential homes interested must complete the form below

as a first step to being considered for one of our puppies.

Name & Surname ............................................................... .......................................................................................................

E-mail .............................................................................................................................................................................................

Street address .............................................................................................................................................................................

Postal address .............................................................................................................................................Code ....................

Cell ............................................... Phone (h) .................................................. Phone (w) .......................................................

Are you interested in a male or a female? .................................. ........................................................................................

Is this the first time with this breed? .......................................................................................................................................

Animals currently at home with you? .....................................................................................................................................

Gender of animals at your home? ...........................................................................................................................................

What activities will you and your dog be involved in eg:

Pet, Companion, Showing, Breeding, Obedience or Working? .......................................................................................

Do you have a fenced in yard? .................................................................................................................................................

Number of children in the household? . ..................................................................................................................................

Ages of children? ...........................................................................................................................................................................

Where will the puppy stay during the day? ............................................................................................................................

Were will the puppy stay during the night? ............................................................................................................................

Will someone be home during the day to feed the puppy?  ...............................................................................................

How were you referred to me? ...................................................................................................................................................

I would like to thank you for taking a moment to answer these questions.

Print, complete and e-mail this questionnaire to: mariekoorts78@gmail.com.