Your Name:

Occupation:

Spouse's Name:

Spouse's Occupation:

Street Address:

City:

State:

Zip:

Contact Phone Number:

Email Address:

Names and ages of all household members:

Veterinarian's Name, Address and Phone Number:

Family Hobbies:

Do you prefer a Male or Female: Male Female

Do you plan to spay/neuter your dog? Yes No

Do you hope to breed your dog?

If so, have you ever whelped a litter, or had a stud dog before? Yes No

If yes, please relate the experience ( be specific):

Do you prefer a certain color or markings?

Do you have other animals in the house? If so, please list breed, age, sex, and if they are neutered.

Have you owned dogs before? Yes No

If so, what breed, how long ago and for how long.

Do you frequently travel? Yes No

Where will your dog be when you travel?

Where will the dog stay during the day if you are not home?

Do you have a fenced yard and if so how large?

Do you plan to show your dog? No Conformation Agility Herding CGC Other

Will you attend obedience and/or conformation classes with your puppy? Yes No

What type of formal training for the puppy do you plan to utilize?

Where are the facilities?

At what age of the puppy will formal training start?

Why are you attracted to a PON?

Describe what you are looking for in your puppy?

Any specific questions that you need answered pertaining to our puppies?

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