Tell Us About You

Name:
Address:
City:		Province/State:		PC/Zip:
Home Phone:		Work Phone:		Fax:
Cell Phone:		Email:
What is the best way to reach you?		Home Phone Work Phone Cell Phone E-mail Other - Descibe in comments
What is the best time to reach you?

 How did you hear of us?

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The following information will help us learn about you and match you with the right puppy.

How did you become interested in the Shiloh Shepherd?

Please tell us why you think a Shiloh Shepherd is the right dog for you:

I would like a  pet quality or a breeding dog?

Do you prefer a male female - Why?

What colour(s) do you prefer?

What type coat do you want? smooth coat plush coat no preference

The temperament I expect from my dog, as per the following possibilities would be;
The mailman knocks at the door with a package to deliver, I want me dog to ,
Bark, then make friends
Bark, and not make friends
Be quiet and friendly

 

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If you are interested in pet quality, will you spay/neuter your dog?

no yes

 If no, please explain why:

Are interested in showing or having your new dog shown?

no yes

 

If no, would you be willing to let me show your dog for you?

no yes

Would you be willing to purchase this dog on a co-own so this dog may be assessed in the future
for quality and possibly be bred by ShadowGate Farm provided the dog passes all expected health testing?

no yes

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Are you living in a House Townhouse Condo Apartment Other

Do you live in a City/Town Suburbs in the Country

Do you rent/own you home Rent Own

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

Do you have a fenced yard? yes no
If yes, how high is the fencing in feet
If no, will you be walking your dog or will you have a dog run?   Walking Dog Run

Do you have a kennel building? yes no

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My household consists of :	# of Adults:		# of Teens:
	# of Children:		# of other Dogs:
	#of Cats:		# of other pets:	Please specify:

My currently owned dogs are, (please list breed, age, sex and if spayed or neutered):

My Children(s) age(s) is (are):

I have owned dogs in the past years

My dogs were	Given away	Killed in accidents
	Died of old age	Euthanized because:

 

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What training will you do with your dog:	Obedience	Search & Rescue
	Agility	Seeing Eye
	Herding	Shutzhund
	Therapy
	Other:

Will you crate train your Shiloh? yes no.  If no, please explain why not:

My dog will spend most of his/her time	In the house
	In a fenced yard
	In a kennel run
	on a chain
	Running loose
	Other:

How many hours a day will the dog normally be left alone?

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

Will you agree to return your Shiloh to ShadowGate Farm should you be unable to keep it?  yes no

If not, please explain why:

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Are you aware of the cost of caring for this puppy? i.e. puppy vaccinations, worming, food, heartworm medication, crate, toys, grooming, etc. yes no

Do you currently have a veterinarian? yes no

Name:

Address, City, State, ZIP:

Phone Number:

May we call him/her to get a reference? yes no

Other References:

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By submitting this application, I (we) authorize the Veterinarian listed on this application to release information to ShadowGate Farm.

Applicant's name: Date:

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Any further questions and/or comments:

Thank You!