Name:

Address:

City, State, ZIP:

Email address:

Home Phone: Work Phone: How did you hear of us?

Where and when did you d iscover the Shiloh Shepherd?

Please take your time answering the following questions; answer all the questions.
Give us as much information as possible; if you need more room,
please use the comment section and label with the correct question number.

Type of Home:

Do you

If you rent, does your landlord permit dogs? yes no

Would you permit us to contact your landlord? yes no

Landlord's name and phone number:

Is your yard fenced?: yes no, if yes what height? c

Members of your family living at the above address: Adults Children

children's ages: Adult ages:

 

What level of quality are you looking for in your Shiloh?

with a Coat Type: in this color:

Have you had a dog in your family before? yes no

What kind was it?

How long did you have them; and the reason you no longer have them now:

Have you had a puppy in your family before? yes no

Will there be anyone home all day with the puppy? yes no

If so, who?

Where will the Shiloh spend the day?

Where will the Shiloh spend the night?

How many hours per day or night will the Shiloh be left unattended?

Are there other pets, what is their gender, age, breed, and whether or not they are spayed/neutered:

Any additional information/comments you would like me to know about you and your family?

Feel free to contact us for more information.

Heather O'Connor
(410) 590-7765