Before acquiring a new puppy, thought needs to be given as to how the puppy will fit into your lifestyle, home and family.  This questionnaire is designed to help you make important decisions prior to purchasing a puppy and to assist us in placing the right puppy with you.  This will enable me match each puppy with the proper home based on the prospective owner’s lifestyle and environment and on the puppy’s personality and abilities. With this in mind, please answer all questions with as much detail as possible.  All information is strictly confidential and will be used only by us.  Thank you for your interest.  

Name:
Today's Date
Email Address:
Street Address:
City, State, Zip:
Best time to reach you:
Phone Numbers (Home/Work/Cell):
Occupation:
When were you looking to acquire a puppy?
Do you prefer a male or female puppy?	Male Female No Preference
How do you plan to get your puppy? We are located in Central VA and do not ship.	Fly "In Cabin" with my puppy Drive
Have you ever owned and American Eskimo Before?	Yes No
If not, have you ever owned a dog before?	Yes No
If so, what kind?
Do you still have it?	Yes No
If not, what happened to it? Please be specific:
How long has it been since you have trained a puppy?
Why have you decided to purchase an American Eskimo?
What type of research have you done on the American Eskimo?
For what purpose are you purchasing this puppy?	Companion Obedience Agility Show Conformation
Are there other animals in the home? (please describe)
How long will your puppy be left alone during the day while you are at work?
Number of Adults in the home:
Number of children in the home:
Please list names and ages of children:
If no children, are there plans for a family in the furute?	Yes No
Are ALL family members in agreement on acquiring an American Eskimo puppy?	Yes No
Do any family members have allergies to or a fear of dogs?	Yes No
Who will be the primary caretaker?
Is this person aware of the time and energy needed to care for a young puppy and willing and able to accept that responsibility?	Yes No
Will the cost of raising and caring for this puppy fit comfortably into your budget?(Initial puppy vaccinations, monthly heartworm medication, annual booster vaccinations, crate, bedding, food, toys, grooming products, flea & tick control, spay,neutering.)	Yes No
Are you committed to caring for this dog for his/her lifetime? (Average life span is 13-15 years).	Yes No
Do you own or rent?	Own Rent
Please describe your home and property:
Please describe a typical weekday in your life (work schedule, etc.)
Please describe a typical weekend:
Where will your puppy be staying during the day? At night? While you are away from home?
What type of outdoor facilities do you have? Securely fenced yard, kennel run, invisible fence, doghouse or other adequate shelter?
Do you padlock your gates (if applicable)?	Yes No
Do you plan to use a crate for housebreaking?	Yes No
If not, what other method do you plan to use?
Have you looked into Puppy Kindergarten/Basic Obedience programs in your area?	Yes No
Are you willing to obedience train this dog through training classes in order that he/she will become an enjoyable companion and canine good citizen?	Yes No
Do you have any experience in any of the following areas? training, showing, breeding, pet therapy work, agility, other? (Please describe, including any titles or achievements earned, number of litters whelped or just general information about other dogs you have owned?
Our puppies, which are sold as family pets, require a spay/neuter contract. AKC papers will be given on a Limited Registration. UKC papers will not be released until a copy of the spay/neuter certificate from a licensed veterinarian is provided. No exception. Is this acceptable to you?	Yes No
Last, but not least, please describe what type of personality you are looking for in your American Eskimo (as an adult dog) and the type of family enviornment in which he/she will be living:
Please list at least 2 references and provide the name and address of your Veterinarian:
This box is for any additional information you want to share with us or any questions you may have for us.

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