South Mtn GSPs Questionnaire

Please provide the following contact information:

First Name
Last Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail
URL

Age
Sex	Male Female

How did you hear about us?

How many hours will puppy be left alone?

Family Information---(others in the household and the ages of any children)

Dog Information---How did you become interested in GSPs?

Do you want a...

Puppy
Adult
No Preference

Do you want a...

Male Female Doesn't Matter

Are you interested in a dog for a...(Select any of the following options that apply)

Pet
Show
Hunt
Other

Are you willing to spay/neuter your dog? (if for pet only)

Yes No

Do you plan to do any of the following with your dog? (Select any of the following options that apply)

Conformation Shows
Obedience
Agility
Jr. Showmanship
Hunting
Therapy Dog Work
Other

Have you ever participated in any of the above activities?

Please list any other pets in your household?

What other dogs have you had in the past (if any)? Include Breed and how long you owned...and why they are no longer with you...

Have you ever raised a puppy?

Yes No

Have you ever obedience trained a dog before?

Yes No

Do you live in a...

House Apartment Condo Farm Other

Do you rent or own?

Rent Own

If you rent, have you gotten a written okay from your Landlord?

Yes No Doesn't apply-I own

Where will the dog stay when no one is at home?

Where will the dog sleep?

How big is your yard?

Do you have a fenced yard?

What type of fence?

How high is your fence?

Please add any additional information that may help us to get to know you...