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Thank you for your interest in our dogs. We appreciate your answering the following questions so that we can more easily test and select the right puppy for you. All information is confidential and used only by us. Thank you for your cooperation and help in answering our questions.
YOUR NAME
ADDRESS CITY STATE ZIP
PHONE NUMBER EMAIL
GOOD TIME TO REACH YOU
HOW WERE YOU REFERRED TO US?
SEX CHESSIE COLOR
WHAT ARE YOU PLANNING ON USING YOUR DOG FOR
ADDITIONAL INFORMATION
WHAT QUALITIES DO YOU LIKE IN THIS BREED?
IS THIS YOUR FIRST CHESAPEAKE/GOLDEN?
ANIMALS PRESENT NOW
ARE YOU COMMITTED TO CARING FOR THIS DOG FOR IT'S LIFETIME?
HAVE YOU EVER HAD TO EUTHANIZE A DOG?
ARE YOU WILLING TO SPAY / NEUTER THIS DOG? IF NOT, WHY?
ARE YOU WILLING TO PUT THIS DOG ON LIMITED REGISTRATION?
DO YOU HAVE
IF YOU DO NOT, WHAT ARE YOUR PLANS FOR THIS DOG?
WHERE WILL DOG STAY DURING THE DAY/NIGHT
FAMILY DATA AGE
NUMBER OF CHILDREN AGES
OCCUPATION
OTHERS IN HOUSEHOLD THAT WILL HAVE CONTACT
DO YOU LIVE IN
HAVE YOU READ ANY BOOKS ABOUT THE BREED? IF SO, WHAT?
Please use this section to add further information you wish us to consider in placing one of our puppies with you. We would appreciate if you would give us a little insight into the expectations you may have for this new addition to your family. Thank you again! Your interest is deeply appreciated.
