TOLLER PUPPY RESERVATION FORM

Your Name:*

Your Address:*

Your Phone #:*

Your Email::

How did you hear about the Toller?:

What reference material have you read on Tollers?:*

Have you ever met a Toller in person?:
yes
no

How long have you lived at your address?:*

What type of dwelling do you live in? House Apt Condo Mobile Home:*

Renting or Own? If renting, give name and contact number of landlord.:*

Who will be the primary care giver for the puppy?:*

Where will the puppy be kept during the night?:*

Where will the puppy be kept during the day?:*

Is anyone home during the day?:*
yes
no

How many hours on the average will the puppy be left alone?:*

Will there be someone available to feed and exercise the puppy during the day?:*
yes
no

Have you ever owned a dog before? What breed?:*

How long did your last pet live? What were the circumstances of its death?:*

Do you have any other animals? If yes, please describe them.:*

Do you have any children? If yes, what are their ages.:*

Are you most interested in a Puppy (8-12 wks) or a young adult (6-18 mo), or retired show dog be OK?:*

What do you expect the activity level of your dog to be? High Moderate Laid Back:*

How will your Toller be confined when he is outside?:*

Do you have a fenced yard or suitable pen?:*
yes
no

Have you ever house trained a dog before?:*
yes
no

Are there training classes nearby? :*
yes
no

What is the predominant training method and do they offer Puppy Kindergarten?:*

Which activities or competitions interest you?:*

Are you interested in showing the dog in the conformation ring?:*
yes
no

Are you interested in competiting in performance events such as obedience, agility, hunting,herding?:*
yes
no

If yes, have you shown a dog to any performance titles?:

Do you intend to breed the dog? Why?:*

Is there any additional info that you would like to offer that will help us place a puppy w/you?:

References: (Please note: All references will be contacted, so include contact information):*

Please type the text below: