Evolution Keeshonden Kellie Siekierski 2529 Whispering Pines Drive Fort Worth, TX 76177 (972) 571-2235 cell or (817) 928-4829 land
PUPPY PURCHASE QUESTIONNAIRE Personal Information
Address Home Phone
City Work Phone
Do you own your own home? YES___ NO____ Do you rent? YES____ NO____ If you rent, does your landlord allow dogs? YES____ NO____ Are there size or weight restrictions? YES____ NO____ If there are size or weight restrictions, what are they? Who lives in your household? Please include yourself and all others including ages of children if any. Is everyone in the household in agreement to purchase a Keeshond Puppy? YES____ NO____ Do any of the above household members have allergies to animals? YES____ NO____ Is anyone home during the day? YES____ NO____ If nobody is home during the day, what provision will be made for the puppy? How many hours during the day will the puppy be left alone? Are you planning on moving in the near future? YES____ NO____ If so, would you have to give up your pet(s)? Your Pet Experience As an adult, have you ever owned a dog, and if so, when? What happened to it? Have you ever had a pet that was stolen from you? YES____ NO____ Have you ever had a pet that disappeared? YES____ NO____ Have you ever had a pet that was poisoned? YES____ NO____ Have you ever had a pet that was hit by a vehicle? YES____ NO____ Have you ever had a pet that died of a disease? YES____ NO____ Have you ever had a pet that you had to get rid of? YES____ NO____ Please explain any “yes” answers above:
Have you ever crate trained a dog? YES____ NO____ Are you willing to use a crate if necessary? YES____ NO____ List all other pets you currently have by type, age, and sex. Please indicate if they are spayed or neutered.
Are all your pets current on their shots? YES____ NO____
General How were you referred to Evolution Keeshonden? . Have you ever owned a Keeshond before? What made you decide to purchase a Keeshond? Have you ever raised a puppy? Have you ever house trained a puppy? Why do you want a puppy? Do you prefer a male or a female, and why? If your preferred sex puppy is not available, would you consider the opposite sex? Have you contacted other Keeshond breeders? If so, please list them: Are you currently on a waiting list for other litters? Are you considering any other breeds and why? Are you interested in showing your dog in conformation dog shows? In obedience or agility shows? Are you interested in breeding? If you are not planning on showing or breeding, does having your Keeshond spayed or neutered bother you? Where will the puppy sleep Do you have a fenced yard? YES___ NO___ Type of fencing? Height? Is your yard completely enclosed with fencing? If you don’t have a fenced yard or enclosure, how do you plan to exercise the puppy? Will the puppy be allowed in all parts of the house? If not, which parts will the puppy be kept out of? Will the puppy be allowed on the furniture? Do you plan to travel with the puppy? Who will be responsible for feeding, exercising, and veterinary care of the puppy?
What type of activities would you like to participate in with the puppy?
References Please list the name(s), address(es), and phone number(s) of your current Veterinarian(s):
Please list at least two personal references with addresses and phone numbers who can attest to your interest in animals:
All puppies are sold on a contract which you will be required to sign. Thank you for taking the time to fill out this questionnaire. We strive to breed quality Keeshonden with sound bodies and temperaments, and are looking to place them into loving, forever homes where they will be a part of the family. _________________________________________________ Signature of Applicant Date _________________________________________________ Signature of Co-Applicant Date Reserving a puppy and what it means: If your application is accepted, you will be asked to send $300 to reserve a puppy. We sell puppies in the order in which we receive the reservation deposits. Please keep in mind whether you are reserving a show prospect or a companion, if at 7-8 weeks when the puppy testing and grading is done to determine show/pets in the litter, if there is not a puppy of your requested designation available, you will be given the choice as to whether you would like a refund of your reservation deposit or if you would like us to keep it to reserve a puppy from our next litter.