Your Contact Information:

FIRST NAME: LAST NAME:

STREET ADDRESS:

CITY: STATE: ZIP CODE

TELEPHONE: E-MAIL:

Ownership Questions:

HOW MANY ADULTS ARE IN YOUR HOME?

HOW MANY CHILDREN? AGES OF CHILDREN?

IS SOMEONE HOME DURING THE DAY? YES NO
YOUR TIME AT HOME SPOUSES TIME AT HOME

OTHER PETS AT HOME? WHAT ARE THEY?

HAVE YOU EXPERIENCE WITH OTHER PETS?
(How long did they live with you, where are they now, etc?)

DO YOU HAVE EXPERIENCE WITH GIANT SCHNAUZERS? YES NO

IF YES, TELL US ABOUT IT:

TELL US A LITTLE ABOUT YOUR PET'S LIVING ARRANGMENTS:

THROUGHOUT THE WHOLE HOME LIMITED TO CERTAIN AREAS OF THE HOME

FENCED YARD UNFENCED YARD DOG RUN OTHER

WHICH PUPPY WOULD YOU PREFER?

MALE FEMALE NO PREFERENCE

WHICH APPEARANCE WOULD YOU PREFER?

CROPPED EARS NOT CROPPED EARS

TELL US A LITTLE ABOUT YOUR FUTURE PLANS FOR YOUR PUPPY (CHECK ALL THAT APPLY):

IF YOU ARE PLANNING TO WORK YOUR DOG IN A SPORT, DO YOU HAVE ANY EXPERIENCE?

YES   NO

IF YES, PLEASE EXPLAIN: