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Potential Puppy Placement Questionnaire
Please answer the following questions honestly. This assures you that the puppy with the most suitable personality and physical ability can be chosen for placement in your home. Please return this questionnaire as soon as you have completed it. Filling out this questionnaire does not guarantee that a pup will be placed with you, but gives us an opportunity to get to know you better. Those who return a completed application to us will be added to our email update list. Email us at any time if you wish to be removed from this email update list, as it is not required to be considered for a puppy. Applications may be shared with other breeders. Date:_________________________________________ Your Name:________________________________________________________________________________________ Names and ages of all family members:__________________________________________________________________ __________________________________________________________________________________________________ Your home address:__________________________________________________________________________________ City/State/Zip:______________________________________________________________________________________ Your Email address:__________________________________________________________________________________ Your telephone number:(cell)__________________________________(home)__________________________________ Number of years at this address:_______________________________________________________________________ 1. Do you own, rent, live with relative, or other (please explain)?____________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ 2. If you do not own your home, do you have permission to keep a pet and to potty train a pet in this location? Please provide a name and phone number for your landlord. _____________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ 3. Do you have a fenced in yard? ____________________If yes, what type of fencing and how high? (wood with slats, solid wood privacy, chain link, etc.) ___________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ If no, how do you and your family plan to give the dog exercise and potty train him/her? ____________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ 4. If you share your home with another adult, how does your partner feel about getting a Chinook? ______________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ 5. Do you work outside your home? ___________________________________________________________________ 6. What is your occupation? ________________________________________________________________________ What is your partner/spouses occupation? ___________________________________________________________ 7. Number of hours your Chinook would be alone at home each day? ________________________________________ _______________________________________________________________________________________________ 8. Does your town have a limit on total number of dogs in a household? ______________________________________ 9. If you currently own other dogs, please list their names, ages, and breeds: ________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ 10. What is the name, address, and telephone number of your current vet if you have one? ______________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ 11. Have you ever owned a Chinook? __________________________________________________________________ 12. Have you ever met a Chinook?______________If yes, whose?___________________________________________ 13. Have you ever owned a dog in the past? ____________________________________________________________ 14. Please describe the cause of death, loss, or reason for giving up any pet you've had in the past. ______________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ 15. Who in your household will be primarily responsible for this Chinook? ______________________________________ _______________________________________________________________________________________________ 16. Where will this Chinook sleep? _____________________________________________________________________ _______________________________________________________________________________________________ 17. Where will this Chinook spend time during the day? ____________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ 18. What do you plan to feed your Chinook? ____________________________________________________________ 19. Have you ever obedience trained a dog? ____________________________________________________________ 20. Would you be willing to obedience train your Chinook in a class setting? _________________________________ ______________________________________________________________________________________________ 21. Do you have access to training classes "using positive reinforcement" near your home? _____________________ ______________________________________________________________________________________________ 22. If it is determined that your Chinook is in need of long term medical care within his/her lifetime, are you willing to commit the resources to do so? ___________________________________________________________________ ______________________________________________________________________________________________ 23. Are you looking for specific coloring or other qualities in your Chinook puppy? _____________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ 24. What is your preference as far as sex of the puppy? __________________________________________________ 25. Would you take the opposite sex if your preference were not available? __________________________________ 26. If a puppy were not available to you with your specific coloring or qualities, would you still be interested in a pup from this litter? _________________________________________________________________________________ 27. Are you looking for a pet that is required to be spayed/neutered or are you interested in a puppy that is potentially breedable as an adult or are you undecided? _______________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ 28. If you are interested in a potentially breedable pup would you be willing to show the pup in conformation shows? ______________________________________________________________________________________________ 29. If you are interested in a pet would you be interested in training for companion events (agility, Obedience, Rally, or Tracking) and entering trials? ___________________________________________________________________ 30. What type of activities do you hope to do with your Chinook? _________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ 31. In filling out this application, I may share your information with other breeders looking for homes for their puppies or dogs. Would you possibly consider taking a young adult Chinook, if one was available, at any point? _______ _____________________________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ 32. How do you feel about being required to keep in contact with your breeder for the life of the Chinook by filling out a questionaire and providing pictures on a yearly basis so that the breeder will know the health and temperament of the Chinook? _____________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ 33. Would you be willing to travel to pick up your puppy? __________________________________________________ Please return to: Patti and Perry Greene Richards Forever Greene Chinooks PO Box 276 Fair Haven, VT 05743-0276 802-265-4883 patti@forevergreenechinooks.com www.forevergreenechinooks.com |
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Forever Greene Chinooks
Patti & Perry Richards, 647 Main Road, West Haven, VT 05743 Phone: 802-265-4883 Email: information@forevergreenechinooks.com
Copyright 2009
