Name
Email
Telephone
Where are you located?
Are you married, in a permanent relationship
or single?
Do you have children?
If yes, what are their ages? (Check all that
apply)
Baby
1 - 3
3 -5
5 - 8
8 -12
Teenager
I currently live in ....
I am currently ....
Will you be spey/neutering your dog?
Do you have a fenced yard? ( Please explain
as best you can.)
Where will your dog live?
When your dog is home alone how will it be
confined?
How long will this dog be left alone
regularly? (Please explain the best you can)
What sex do you require?
Do you have a preference on colour? Please
explain
I am looking for ...
Baby puppy 8 weeks - 3 months
Puppy
3 - 6 months
Juvenile 6 months +
Adult
- Ex show or breeding Pomeranian
When do you want to get a puppy?
Looking
now
In 1 - 2 months
3 -
6 months
Just enquiring
What type of activities would you like to do
with your dog? Check all that apply.
Family Pet, Companion
Conformation Sowing
Obedience and/or Performance Events
Therapy Dog
Breeding
Anything else you would like me to know about
you?
