TimberPoint Kennels Puppy Questionaire

Personal Information

Name *

First
Last
Address

Street Address

Address Line 2

City
State / Province / Region

Postal / Zip Code
Country
Email *
Phone Number *

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Which breed are you inquiring about? *
Do you have children? If so, how many?
Are you interested in a male or female ? *
Have you ever owned the breed you are inquiring about? *
 yes 
 no 
What age are you looking to purchase? *
How soon are you looking to purchase a dog? *

MM		/
DD		/
YYYY
Are you looking to purchase a pet/companion or show prospect? *
Do you own or rent? *
 own 
 rent 
Do you have a fenced yard? *
 yes 
 no 
Do you currently have other pets? if so, please list below. *
Where will your dog be spending the majority of it's time? *
Are you interested in breeding your dog? *
 yes 
 no 
May we contact your veternarian for a reference ? If so, please list name and number.
Please tell us anything us you would like us to know about you and your family.
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