* Date:

How did you hear about us? Select One Google Yahoo MSN Bing Other Search Engine Referred by friend Just Surfed In Other

* First Name:

* Last Name:

* Address:

* City:

State: Select One AK AZ AR CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT EN NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

* Zip Code:

* Phone Number:

Cell Phone:

Work Phone:

* Email:

Other Applicant - (If there is one):

First Name:

Last Name:

Address:

City:

State: Select One AK AZ AR CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT EN NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

Zip Code:

Phone Number:

Cell Phone:

Work Phone:

Email:

Home: Select One House Condo/Townhouse Apartment

If renting, do you have permission from your landlord to have a pet?

Select One Yes No

Have you ever owned a dog before?

Select One Yes No

Have you ever owned a German Shepherd before?

Select One Yes No

* Besides yourself, list the name and age of any other occupants of your home?

* List the breed, species, and age(s) of any other pets in your home that will come into contact with this German Shepherd:

Does anyone in your household have allergies to dogs? Yes No

If yes, to the preceding question, how severe are those allergies:

Have you ever returned a dog or dog before?

Select One Yes No

Have you ever given an animal away or relinquished an animal to the pound or animal shelter?

Select One Yes No

Name of your veterinarian:

Address and telephone number of the above-referenced veterinarian:

Name of pet-related reference:

Address and telephone number of the above-related reference:

May we contact your veterinarian and pet-related reference?
Yes     No

Do you have a preference for the sex of a German Shepherd?

Select One No Preference Male Female

What age German Shepherd are you looking for?

Select One No Preference Puppy Teenager Adult

Would you be willing to consider a puppy with a long coat?

Select One Yes N o

Do you have a color preference?

Select One No Preference Yes No

If you have a color preference, choose your first choice color preference:

Select One Black and Tan Bi-Color Sable

Second color preference: Select One Black and Tan Bi-Color Sable

Third color preference: Select One Black and Tan Bi-Color Sable

What quality puppy do you prefer? Select One Pet-spay/neuter contract Breeder Quality Show Quality

Have you read our Contract/Health Guarantee?

Select One Yes No

Are you willing to abide by the Contract/Health Guarantee?

Select One Yes No

Are you willing to continue to feed this puppy Life's Abundance dog food in accordance with the Health Guarantee?

Select One Yes No

Are you willing to continue giving this puppy the Life's Abundance Daily Supplement AND Agility Supplement throughout its life?

Select One Yes No

If you are interested in a pet/companion dog, would you accept a Limited Registration on your dog? (A Limited Registration registers your dog with the AKC, but does not allow any offspring of the dog to be registered.)

Select One Yes No

If you are interested in a pet/companion dog, would you be willing to have the dog spay or neutered?

Select One Yes No

Are you willing to finish registering this puppy with the American Kennel Club (the litter is registered with the American Kennel Club, but you have to register the individual puppy in your name)?

Select One Yes No

Are you willing to provide this puppy with the proper care and nutrition throughout its lifetime as outlined in the Health Guarantee?

Select One Yes No

Are you willing to keep current any vaccinations as required by your veterinarian or by local law?

Select One Yes No

Who will be the primary caregiver for this puppy?

Is anyone home during the day?

Select One Yes No

How many hours (on average) will the puppy be left alone?

Where will this puppy be kept during the day?

Where will this puppy be kept during the night?

If you are interested in a show or breeding quality dog, do you promise to have this dog x-rayed for hip and elbow dysplasia and certified free of same by the OFA prior to breeding?

Select One Yes No

Are you willing to take your puppy to obedience and/or puppy obedience classes?

Select One Yes No

Why do you want a German Shepherd Dog?

Is this your first dog? Select One Yes No

Have you ever owned a German Shepherd Dog? Select One Yes No

If yes, from whom did you get him/them?

If no, have you spent time with the breed?

Select One Yes No

What kinds of previous experience have you (and/or the members of your household) had with dogs? And what breeds?

Are you interested in any of the following? (please check all that apply)

Home:
Watchdog  
Trained Guard Dog  
Companion/Pet  

Hobby:
Obedience  
Tracking  
Herding  
Therapy  
Other  

Competition:
Show/Conformation  
Obedience  
Herding  
Tracking  
Other  

If yes, to any of the above, how strong is your interest?

Might you be willing to let another person train and show your dog?

Select One Yes No

Might you be interested in joining the local German Shepherd Dog Club?

Select One Yes No

Might you be interested in joining the national German Shepherd Dog Club?

Select One Yes No

What qualities do you like in the German Shepherd Dog?

What qualities do you NOT want to find in a German Shepherd Dog?

Please tell us anything else you would like us to know about you, to help us make a decision.