Questionnaire

QUESTIONNAIRE FOR PROSPECTIVE PURCHASERS

Name___________________________________________________________

Address_________________________________________________________

City_______________________ State _______________Zip________________

Res. Phone _____________________Bus. Phone_________________________

Email____________________________________________________________

Name of Spouse/Companion_________________________________________

Names and ages of Children__________________________________________

Is there anyone else who will be living with the dog?______________________

Have you ever owned a Cardigan Welsh Corgi?__________________________

Have you previously owned a dog?____________________________________

If yes, please provide the following for each dog you have owned:
(Attach a separate sheet if necessary)

-Breed (or prevalent breed if mixed)___________________________________

-How obtained (purchased, found, adopted, etc.__________________________

-Age when obtained________________________________________________

-What happened to the dog (sold, given to others, lost, died (include cause of death)):







What animals do you currently own?___________________________________

Do you breed dogs now, or have you had experience breeding dogs?__________

Which of the following reasons best fit the primary reason(s) you would like to have a dog? If you mark more than one, please put a "1" by the most important, and a "2" by the next most important, etc.

For spouse Companion Agility Showing

For other pet Herding showing Breeding

Attack/protection Conformation showing Obedience showing

Tracking Showing For the children

What specifically attracted you to the Cardigan Welsh Corgi? How did you become interested in owning one?







Do you prefer a male or a female?_________________________________________

Why?_______________________________________________________________

Do you have a color preference?__________________________________________

If you are not planning on showing and breeding, would you be willing to have your Cardigan Welsh Corgi spayed or neutered?




Please provide the following information about your facilities and care of the dog?

-Your Occupation_______________________________________________________

-Work Schedule________________________________________________________

-Typical Hours per Week_________________________________________________

-How many hours per day would the dog be left alone?_________________________

-Who will be the primary caretaker for the dog?_______________________________

-Do you own your own home?_____________________________________________

-If not, landlord’s name and phone number for approval________________________

-The dog would spend most of its time (circle one) Outdoors    Inside the Home

-The dog’s sleeping quarters would be (circle one) Outdoors    Inside the Home

-Description of outdoor space for the dog:





-Fenced Yard (give type)_____________________________________________

-Unfenced Yard

-Open Fields

-Kennel Run

-Garage

-Other (describe)___________________________________________________

-Parks nearby



May I come and see your facilities?_______________________________________

How will your dog be transported?_______________________________________

How will you exercise your dog?_________________________________________

When you travel, would you normally travel with the dog?_____________________

What arrangements would you make for the care of the dog when it is unable to go with you?

Is anyone in your family allergic to dogs or dog hair?_________________________

Please consider what you will do with your dog in any of the following situations were to happen to you:

Divorce



Moving



New baby in the home



Loss of job or serious illness



Are you at all interested in being contacted about Rescue dogs or older dogs needing placement if I should come across a dog that I feel would suit your needs? Yes    No

Were you referred to me by anyone in particular?____________________________

If so, who?___________________________________________________________

Veterinarian name and phone number (please contact your vet and ask permission for me to make a reference call)




Please give two personal references (name, phone, relationship)






Any other comments or conditions to be included in the contract?________________






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