These questions are to assist you and Semper Fi Shilohs in obtaining the breed and the puppy that is right for you. We have been watching the puppies and monitoring their temperament and behavior. Now we need to know about you and your household so we can match the two. The information is not meant to be judgmental in any way, rather it is meant to be informational. To that end, please be candid with your replies. Each puppy has its own needs. For example, one may function best in a quiet environment while another may require a lot of stimulation to be happy.

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Name:* Email Address:*

Address:

City: State: Zip: Country:

Home Phone:* Work Phone:

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Please answer the following questions
and if there is anything elese you want us to know, please add that information, too.

1. Which sex do you prefer? female male

2. What temperament do you expect? What type of personality are you looking for your dog?

3. Describe your current family in the home. Do you have children, if yes, what ages? Are they in the home or do they visit (shared custody)? If you do not have children now, do you plan to expand your family? How soon?

4. Do you have a person living in the household that is Elderly Handicapped has special needs

5. Does anyone in the household have allergies? no yes, what type?

6. How would you describe your family lifestyle?

7. What types of family recreation do you enjoy?

8. What breeds of dogs have you owned or do you currently own?

If currently in the household, are they spayed/neutered? yes no

Ages:

Current breeds in the household:

9. Have you ever raised a puppy? yes no - If so, from what age?

10. Of the dogs you have owned what happened to them? given away killed in accidents died of old age, euthanasia other (please expain)

because:

other reasons:

11. What other animals have you, or do you, own?

12. What have you done with your previous dogs/animals? Obediece Agility Search & Rescue Therapy/Assistance Schutzhund Herding Other

13. Have you ever had to put a dog to sleep? yes no

14. Which family member will have the major responsibility for the dog?

15. Do you own rent

If you rent, does your landlord permit dogs? yes no

Would you permit us to contact your landlord? yes no

Landlord's name and phone number:

16. Do you have a fenced yard? yes (in feet) and type no

If no, are you able to leash walk your dog at least 4 times daily for necessary functions and exercise? yes no

If no, why not?

17. Where & how will the puppy be housed?

18. My dog will spend most of his/her time: in the house in a fenced yrd in a kennel run on a leash/chain loose other (please explain) , if other, please explain

19. How will you be housebreaking your new puppy?

20. What classes do you plan on using to train your puppy?

21. Are you willing to keep the dog up to date on all of its vaccines, screen for heartworm, use heartworm preventative and use flea preventative? yes no

22. Are you willing to have your dog seen by a vet at least once a year? yes no

23. Do you already have a veterinarian? If so, who?

Name:

Address, City, State, ZIP:

Phone Number:

24. When a puppy is purchased as a family companion (non-show dog), it is agreed it will be spayed/neutered. Can you agree and follow through with that procedure? yes no

25. If this puppy is purchased for show and breeding, do you agree to complete all the required tests and breed only if the tests indicate the dog is an appropriate breeding animal? yes no

26. Do you agree to return your Shiloh to us at Semper Fi Shilohs if you are unable to keep it? yes no

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Any further questions and/or comments you may have can be included with this application. Please make your comments below:

Feel free to contact us for more information. Thank you for your interest in Semper Fi Shilohs.

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