Reservation Questionaire

Your Name:*

Your Address:*

Your Phone #:*

Your Email::*

Have you been referred by someone?:
yes
no

How did you hear about the Schipperke?:*

What reference material have you read on Schipperkes?:*

How long have you lived at your address?:*

Is this a: House Condo Apartment Mobile Home:*

If Renting, give contact info on Landlord:*

How long will the puppy be alone during the day?:*

Have you owned a dog before?:*
yes
no

What breed(s)? And how long did the pet live?:*

Do you have other animals and children?:*
yes
no

What kind of animals and how old are your children?:*

Are you interested in a male or female puppy? And why?:*

What activity level do you expect a Schipperke to be?:*

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

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

Are there puppy and training classes available?:*
yes
no

Are you interested in showing your dog or competing in performance?:*
yes
no

Are you interested in breeding your Schipperke?:*
yes
no

Please Give References along with contact information. They will all be contacted.:

Your veterinarian:*

Friend or Neighbor:*

Co-worker:*

Please type the text below: