Questionnaire 2014

Applicant Name

Spouse Name

Spouse Employer

Children and Ages

Street

City

State

Zip

Phone

Email

Desired Characteristics

Male or Female

 Male Female

Do you have a fenced yard

 Yes No

Interested in Older Dog

 Yes No

Will you crate your Dog

 Yes No

Who will do the weekly grooming?

Previous Dog Experience

 Yes No

If Yes Please give details

Comments and Additional Questions