ALL ANSWERS ARE CONFIDENTIAL.  THE PURPOSE OF THIS QUESTIONNAIRE IS TO ASSIST THE BREEDER TO FIND THE BEST MATCH AND THE BEST HOME FOR OUR PUPPIES.  IF YOU ARE NOT A SUCCESSFUL APPLICANT, THIS FORM WILL BE DESTROYED.
 

DATE

NAME

ADDRESS:
 

TELEPHONE # HOME:
                         WORK:
                        CELLULAR:
                        EMAIL ADDRESS:

YOUR EMPLOYER: Both Spouses please answer

 NAME  ADDRESS AND PHONE NUMBER OF A CONTACT THERE.
 

HOW LONG THERE?  (if less than 2 years previous employer)

WHO ARE YOU BUYING THE PUPPY FOR?

IS IT A SURPRISE FOR SOMEONE?
HAVE YOU OWNED A DOG BEFORE?

WHAT BREED?                                            HOW LONG?                    HOW MANY IN HOME NOW?

WHY ARE YOU INTERESTED IN A GOLDEN RETRIEVER?
 

WHAT ARE YOUR ACTIVITIES OUTSIDE WORK? PLEASE DESCRIBE WHAT YOU EXPECT TO DO WITH YOUR DOG?
 
 
 

WHAT ACTIVITY; ENERGY LEVEL TO YOU WANT IN A GOLDEN RETRIEVER/GREAT PYRENEES?  HIGH_________MEDIUM______LOW_____
WHAT BOOKS HAVE YOU READ IN REGARDS TO RAISING A PUPPY AND A GOLDEN ?
 

ARE YOU PURCHASING THE DOG FOR OBEDIENCE, FIELD WORK, AGILITY, GUARDIAN, COMPANION, SHOWING, BREEDING OR OTHER  (please specify)
 

DO YOU PLAN TO SPAY OR NEUTER YOUR DOG?  YES________NO__________
WHERE WILL THE DOG LIVE?  OUTSIDE OR INSIDE?  IF OUTSIDE, IN A DOG HOUSE AND RUN?  A FENCED SAFE AREA OUTSIDE?  TIED OR CHAINED OUTSIDE?  CONFINED IN A SHED OR BARN FOR PART OF THE DAY?

WHERE WILL YOUR DOG SLEEP AT NIGHT?  BESIDE YOUR BED IN A CRATE?    IN YOUR ROOM IN A CRATE?    IN THE BASEMENT IN A CONFINED AREA?      IN THE PORCH  OR OTHER CONFINED AREA?  OUTSIDE IN A RUN OR A DOG HOUSE WITH A SAFETY CHAIN?

HOW MANY CHILDREN DO YOU HAVE?
ANY UNDER THE AGE OF 4?                        IF YES, HOW MANY?

WHAT OTHER PETS OR LIVESTOCK DO YOU HAVE?

IS YOUR YARD FENCED?   IF SO, HOW HIGH?

ARE YOU FINANCIALLY ABLE TO CARE FOR A DOG?
HOW MUCH DO YOU THINK IT COSTS TO CARE FOR A DOG PROPERLY?

HAVE YOU EVER TAKEN OBEDIENCE COURSES?
DO YOU PLAN TO TAKE THEM WITH THIS  DOG?             WOULD YOU MIND IF THE BREEDER MAKES THIS A REQUIREMENT IN YOUR CONTRACT? ___________

WHAT SEX OF DOG DO YOU PREFER?                WHY?
 

HOW DO YOU PLAN ON EXERCISING YOUR GOLDEN?  WOULD YOU EXERCISE YOUR DOG WITH YOUR VEHICLE? (e.g. the dog running along side the vehicle.) e.g.: TAKING IT JOGGING WITH YOU IN THE MORNING.
 

ARE YOU WILLING TO FEED THE BEST QUALITY FOOD RECOMMENDED BY THE BREEDER?

WOULD YOU BE IN AGREEMENT TO HAVE YOUR DOGS HIPS, ELBOWS, EYES AND HEART TESTED BY A CERTIFIED VETERINARIAN AT THE AGE OF TWO IN ORDER TO MAINTAIN THE INTEGRITY OF THE  BREED?_______
THE COST OF THIS IS APPROXIMATELY $400.00.

DO YOU OR ANYONE IN YOUR FAMILY SMOKE?

DO YOU HAVE A REGULAR LAWN SERVICE?

WHAT WOULD BE A TYPICAL DAY FOR YOUR FAMILY?  PLEASE OUTLINE A WORK DAY AND THEN A WEEKEND.

HOW MUCH EXERCISE DO YOU THINK A GOLDEN RETRIEVER REQUIRES PER DAY?

HAVE YOU EVER HAD TO GET RID OF A DOG OR TURN ONE OVER TO THE SPCA.

PLEASE PROVIDE 4 REFERENCES, WHO KNOW HOW YOU ARE WITH ANIMALS.  YOUR VET IS USUALLY A GOOD ONE. Please provide name, phone number and address
 
 

Please do not be offended by these questions.  This questionnaire is for the sole purpose of the health and happiness of our Dogs.  Thanks you for your time.  Please return the questionnaire to:
 

Green Acres Theme Song