Snowshoe Samoyeds Application

Date

MonthDayYear

Name:

First NameLast Name

Phone Number:

Area CodePhone Number

E-mail Address:

Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

How were you referred?

Other:

References Please list two (2) references that are familiar with your work life.

Reference 1

Name:

First NameLast Name

Phone Number

Area CodePhone Number

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Reference 2

Name:

First NameLast Name

Phone Number

Area CodePhone Number

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Marital Status

Other

Number & Ages of Children

Does anyone in the household smoke?

Does anyone in the household have allergies?

Does everyone in the household want a puppy at this time?

Is this a surprise gift?

What are the family's hobbies?

Where do you live (city, country, etc)?

Do you rent or own?

If you rent, have you discussed the puppy with your landlord?

If other please explain:

Do you have neighbors? If so, have you discussed the puppy with them? Do your neighbors have any problems or concerns with the puppy?

Please describe your yard: size, fenced or not fenced, surrounding properties.

How do you plan to exercise your puppy?

Have you ever owned a dog before?

What pets do you currently own? (Breed, Age, Spayed/Neutered)

Do you currently have a veterinarian? If so, please list name and phone number.

Have you ever owned a Samoyed before?

Why have you chosen a Samoyed?

Why do you want this puppy?

If other please explain:

Do you prefer a male or female?

If the puppy of your preference is not available are you willing to accept a puppy of the opposite sex?

Are you willing to have this puppy spayed/neutered?

If no, please explain:

Are you willing to wait until the puppy is 16 months of age to spay/neuter?

Is anyone home during the day?

How many hours each day will the puppy be home alone? Please describe your daily routine.

Where will the puppy spend the majority of the day?

Will the puppy be allowed on the furniture?

Do you expect any major changes to your daily schedule or living environment in the next 2 years?

Where will the puppy sleep?

Where will the puppy stay when you are not home?

While on vacation who will care for this puppy?

How will you care for and train this puppy?

How do you plan to care for and maintain your puppy's coat?

Would you allow me or someone I know to visit your home? If no, please explain.

If for any reason you are no longer able to keep this puppy are you willing to return him/her to me?

Are you willing to keep in touch with me throughoutthe lifetime of this puppy?

Please provide any additional information you would like me to know.