CwnAnnwn Yorkshire Terriers Reg - Puppy Questionnaire

How did you hear about CwnAnnwn Yorkshire Terriers?*
Date*

DayMonthYear
Helps with our waiting lists
Name*

First NameLast Name
E-mail*
City*
Province/State*
Phone Number

Area CodePhone Number
General Questions

Please answer the following general questions:
Have you ever Owned a Yorkshire Terrier?*

Yes - PurebredYes - MixedNo
Do you currently own Pets?*

YesNo
Please List any Pets you have Living in your home
Please include Name, Breed, Age,and sex of pet
Are your Pets spayed and/or neutered?*

YesNoN/A
If your current pets are not spayed/neutered please tell us why they aren't
Have you ever had to put your pet to sleep or euthanize him/her?*

YesNoN/A
Please tell us why you had to put an animal to sleep or euthanize
Do you have a preference in sex of your Yorkie?*

MaleFemaleNo Preference
Are you aware that our puppies are placed on Non-breeding contracts?*

YesNoLooking for a breeding dog
Are you willing to consider an adult Yorkshire Terrier?*

YesNo
What age would you consider?
An age range
The lowest you would you expect to pay for a Yorkshire Terrier puppy/adult? Do not use zero.*
Please enter an actual amount
The highest you would expect to pay for a Yorkshire Terrier puppy/adult? Do not use zero. *
Please enter an actual amount
When are you planning on purchasing a Yorkshire Terrier?*
What colour, temperament, size etc do you expect of your Yorkshire Terrier?*
About Yorkshire Terriers

Have you had experience with or researched the following:
Grooming Requirements: Including Coat, Teeth and nails?*

YesNoNo but willing to learnI am researching
Nutritional and Diet needs?*

YesNoNo but willing to learnI am researching
We cannot guarantee a dog to be housebroken. Are you willing to give time and dedication required for potty training?*

YesNoNo but willing to learnI am researching
What are the hazards of allowing excessive jumping? (I don't know is a valid answer)*
Please do not use Yes or No - explain
What is the difference between a small breed dog wearing a collar versus a harness? (I don't know is a valid answer)*
Please do not use Yes or No - explain
What are some reasons for or against feeding table scraps? (I don't know is a valid answer)*
Please do not use Yes or No - explain
Daily Living

Some questions about your daily living
Do you live in a:*
Do you:*

OwnRentLive with ParentsOther
If you rent will you provide your Landlord's contact information?*

YesNoI do not rent
Do you have a fenced yard?*

YesNoPartial
Describe your Homes Activity Level*

Busy/NoisyModerate Comings/GoingsQuiet with Occasional Guests
How many children commonly visit or live in the Household (Include Age)*
Please include the number of children and their ages
Does Anyone in your Household have Allergies to Animals?*

YesNo
Are all members of your Family agreeable to Getting a Yorkshire Terrier?*

YesNo
Will there be someone home throughout the day?*

YesMost of the dayNo - I work
How many hours in a day would the Yorkshire Terrier be left alone?*
Where would this Yorkshire Terrier be housed when no one is home?*
There are no wrong answers!
Are you willing to keep in touch with CwnAnnwn Yorkshire Terriers Reg?*

YesNo
How do you plan to get a Yorkshire Terrier to you?
Please include any additional information you feel we should know about you, your family or your lifestyle.
We are equal opportunity! Yorkies are very adaptable!
By sending this electronically, I acknowledge that submitting this questionnaire does not ensure approval for a placement of a Yorkshire Terrier.

I certify that the above information is correct, and I understand that the information may be verified with/by submitting references.
Should be Empty:

General Questions

About Yorkshire Terriers

Daily Living