Name*
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Telephone Number*
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| Email*
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I am interested in
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| 1. Has anyone in your household ever owned a dog?
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If yes, how long ago and what were the last two breeds? |
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Breed & Date - Dog 1
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Breed & Date - Dog 2
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| 2. Do you have any other pets at the present time?
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If yes, what kind and age? Example: Cat - 6 years old, Lab - 2 years old |
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| 3. How many adults live in your household?
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What are their ages?
19-25 ---
26-35 ---
36-45 ---
46-65 ---
66 & up |
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| 4. How many children live in your household?
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What are their ages?
0-3 ---
4-6 ---
7-12 ---
13-15 ---
16-18 |
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| 5. How much time does your family spend doing outdoor activities?
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i.e. - boating, ball, horses, etc. |
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| 6. How much time does your family spend doing indoor activities?
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i.e. - movies, video games, crafts, etc. |
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| 7. Does your family live in a
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| 8. Is your home located in a high traffic area?
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| 9. Describe the personality of the person most responsible for the discipline and training of your Westie in five words or less. Example - submissive, strong willed, mild tempered, assertive, organized, etc. |
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| 10. How much time will your Westie be home alone?
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11. What future plans do you have for your Westie? |
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Service/Therapy
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Terrier/Agility Trials
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Conformation Showing
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Breeding
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| 12. Which gender do you prefer?
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| 13. When would you like your puppy/adult?
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| 14. Would you like to reserve a puppy/adult with a small deposit?
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