Your Name:
Occupation:
Spouse's Name:
Spouse's Occupation:
Street Address:
City:
State:
Zip:
Contact Phone Number:
Email Address:
Children's Names and Ages
Veterinarian's Name, Address and Phone Number:
Family Hobbies:
Do you prefer a Male or Female:
 Male Female
Do you plan to spay/neuter your dog?
 Yes No
Do you hope to breed your dog?
 Yes No
If so, have you ever whelped a litter, or had a stud dog before?
 Yes No
If yes, please relate the experience ( be specific):
Do you prefer a certain color or markings?
Do you have other animals in the house? If so, please list breed, age, sex, and if they are neutered.
Have you owned dogs before?
 Yes No
If so, what breed, how long ago and for how long.
Do you frequently travel?
 Yes No
Where will your dog be when you travel?
Where will the dog stay during the day if you are not home?
Do you have a fenced yard and if so how large?
Do you plan to show your dog?
 No Conformation Agility Herding CGC Other
Will you attend obedience and/or conformation classes with your puppy?
Yes No
What type of formal training for the puppy do you plan utilize?
Where are the facilities?
At what age of the puppy will formal training start?
Why are you attracted to a PON?
Describe what you are looking for in your puppy?
Any specific questions that you need answered pertaining to our puppies?