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NAME_________________________________________________________________________________________ ADDRESS________________________________________CITY__________________________________________ STATE___________ ZIP________________ HOME PHONE____________________WORK PHONE_______________ E-MAIL ADDRESS__________________________________OCCUPATION___________________________________ HAVE YOU EVER OWNED A BLOODHOUND BEFORE? YES ________ NO________ DO YOU PREFER A: MALE ?__________FEMALE ?___________UNDECIDED ?___________ WHY HAVE YOU DECIDED TO PURCHASE THIS PARTICULAR BREED? ______________________________________________________________________________________________ ______________________________________________________________________________________________
WHAT TYPE OF PERSONALITY ARE YOU LOOKING FOR IN YOUR PUPPY? ______________________________________________________________________________________________ ______________________________________________________________________________________________ DO ALL FAMILY MEMBERS AGREE TO THE PURCHASE OF THIS PUPPY? YES _______ NO _________ DO YOU HAVE YOUNG CHILDREN? YES ________ NO __________ IF SO, WHAT ARE THEIR AGES? ___________________________________________________________________ DO YOU CURRENTLY OWN ANY OTHER DOGS? YES?_________ NO?________ IF YES, PLEASE LIST BREEDS AND AGES________________________________ DO YOU OWN OTHER PETS? YES ________ NO___________ IF YES, WHAT TYPE(S)_________________________________ DO YOU OWN OR RENT YOUR HOME?____________________ DO YOU LIVE IN A HOUSE ?______APARTMENT ?________ OR OTHER ____________ DO YOU HAVE A FENCED YARD? YES______ NO______ DO YOU HAVE A KENNEL? YES _______ NO _______ DO YOU OWN A CRATE? YES ________ NO________ WHERE
WILL YOUR BLOODHOUND BE KEPT DURING THE DAY?
WHERE
WILL YOUR BLOODHOUND BE KEPT AT NIGHT?___________________________________________________
FOR WHAT PURPOSE(S) DO YOU WANT TO PURCHASE A BLOODHOUND? (Circle all that apply and rank by number in order of importance)
FAMILY PET
AKC TRACKING
ARE YOU
WILLING TO SPAY/NEUTER THIS DOG? YES ________ NO________
HAVE
YOU EVER HAD A DOG EUTHANIZEDYES _________NO______________
DO YOU
HAVE A REGULAR VETERINARIAN? YES________ NO___________
_______________________________________________________ _______________________________________________________ _______________________________________________________ HOW DID YOU HEAR ABOUT US ______________________________________________________________________ ______________________________________________________________________ PLEASE LIST TWO PERSONAL REFERENCES (name, address, phone #) 1)________________________________________________________ __________________________________________________________ __________________________________________________________
2)________________________________________________________ __________________________________________________________ __________________________________________________________
______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________
SIGNATURE__________________________________________________________ DATE___________________ PLEASE FILL THIS FORM OUT COMPLETELY AND RETURN WITH $100 DEPOSIT TO: Piney Creek Kennel
Kim Burnett 1920 CR 3630 Lamar, AR 72846 479-885-2125 |