Please provide the following contact information:

Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Home Phone
E-mail

Why do you want a dog?

Why have you decided on a golden retriever?

Have you owned a dog(s) in the past?

YES
NO

If so, what breed?

Do you currently own any other pets?

YES
NO

Do you prefer a male or a female?

MALE
FEMALE
NO PREFERENCE

Why?

If your first choice (male or female) is not available, would you be willing to take a puppy of the opposite sex?

YES
NO, WOULD WAIT FOR ANOTHER LITTER

What type of personality are you looking for?

COUCH POTATO
MIDDLE OF THE ROAD
HUNTING COMPANION
ACTIVE
INDEPENDENT

Why? (please be as detailed as possible)

What are your most important reason(s) for purchasing a Golden Retriever? Please check all that apply.

FAMILY COMPANION
SHOW DOG
BREEDING
OBEDIENCE
COMPETITION
HUNTING/FIELD
AGILITY/FLYBALL COMPETITION
PET THERAPY

Do the other members of your family also want to get a puppy?

YES
NO

Do any members of your family have any types of allergies to dogs?

YES
NO

Describe your family including the ages of any children in your home.

Do you live in a house or an apartment?

HOUSE
APARTMENT

If you rent have you checked with your landlord about getting a dog?

YES
NO

Is your yard fenced?

YES
NO

If not, how do you plan to keep the dog safe when it is outside?

Where will your golden live?

HOUSE
OUTSIDE

Where would the puppy or dog be housed during the day if no one is home?

How do you plan to housebreak your new puppy?

Do you plan to attend obedience classes with your puppy?

YES
NO
UNDECIDED

Have you completed any AKC titles on other dogs?

YES
NO

Please list titles

Do you have a veterinarian?

YES
NO

If this puppy is being purchased as a family companion do you agree to have it spayed by 9 - 12 months of age or neutered no later than 1 year of age?

YES
NO

Are you willing to submit a veterinarian certificate to the breeder as proof of surgery?

YES
NO

Have you ever bred a dog(s) before?

YES
NO

If yes please describe.

If this is a show puppy are there references you would like to list? i.e.: Breeders, trainers, handlers, vets etc.

If you have owned other show puppies please list from whom they were purchased.

If this is a show puppy will you being showing it yourself or hiring someone to show for you?

How did you hear about our kennel?

Is there anything else we should know about you or your family?