Name
First Name
Last Name
Full Address
Contact #
1. How would you describe your residence? Choose one.
2. Do you have children (18 and under)? ** If YES, what are the ages of your children?
3. Do you currently have any pets in your home? Give details (species, breed, age, spayed/neutered)
4. Which type of lifestyle is most like yours: (Select one)
5. How would you describe your experience with dogs? Select one.
6. What size dog are you interested in? Check all that apply.
7. What top 3 dog breeds are you interested in? (Please be specific about what breeds best suit your lifestyle. This is a required question.)
*
8. What energy level are you looking for in a dog? Select one.
9. What age are you looking for in a dog? Check all that apply.
10. What gender are you interested in? Select one.
11. How many hours would your dog spend alone (no human presence) per day on average?
12. Are there any common behaviour issues that you would be UNWILLING to work with?
Other:
13. Do you have any special circumstances or information not yet covered that you would like us to know?
