E-mail Address: * | |
Name: * | |
Age: | |
Address: * | |
City: * | |
State * | |
Zip: * | |
Phone: * | |
Fax: | |
Your Home Environment |
Which of the following best describes your current residence? (Check one) * | Own Home Rent/Lease Home Rent/Lease Apartment Other |
Neighborhood * | Urban Suburban Rural |
Do you have a fence? * | Yes No |
Type of Fencing * | |
Fence Height * | |
Type of Gates * | |
Is fence solid & secure? * | Yes No Invisible Fencing |
If you have children at home, please list ages and gender: | |
Will there be other children who will visit on a regular basis? | |
Who will care for the dog on a daily basis? * | |
Does this person approve of getting the dog? | |
Please list other persons (and ages) in the household who will have contact with the dog. | |
Other pets presently in the household [Breed, Type, Age, Sex of each] | |
Are the above animals spayed/neutered? | Yes No |
Who will be your veterinarian? * | |
Vet Telephone Number: * | |
What dogs have you previously owned? (Please provide a brief explanation about how long you owned them and what happened to them.) | |
For what reason(s) would you give up a dog? | |
Has your dog ever caused you to be in a court situation? * | Yes No |
If yes please explain why: | |
Are you familiar with the temperment & characteristics in general of welsh terriers? * | Yes No |
Preference for Welsh Terrier Sex? * | |
Preference for Welsh Terrier Age? | |
Any other requirements? | |
How often and for how long will the dog be at home alone? (i.e. with no human family member) * | |
Does everyone in the household work? * | Yes No |
Hours per week | |
Where will the dog be kept during the above hours? | |
Where will the dog be kept during the night? [as a puppy] | |
Where will the dog be kept during the night? [as an adult] | |
Do you have a pool? * | Yes No |
If yes, what barriers will be/or are installed to prevent the puppy from falling into the pool? | |
On vacations, what would you do with the dog? | |
How will the dog get exercise besides a fenced enclosure? | |
Do you know anyone who is a member of the Welsh Terrier Club of America Inc or anyone who owns a welsh terrier? * | Yes No |
Why do you want a welsh terrier? * | |
How would you describe the trainability and temperment of a welsh terrier? | |
What method would you use for training? * | |
Any additional comments youd like us to consider? | |
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