Your Name:

E-mail address:

Mailing Address:

Street Address (if different)

Phone: HOME ( ) WORK ( )

* * *

Please list 2 references:

Reference #1:

Name

Phone ( )

Address

Relationship

E-mail address

Reference #2:

Name

Phone ( )

Address

Relationship

E-mail address

* * *

Questions:

1. Please check your preference

_____ Male _____ Female _____Either

Are you willing to spay/neuter a pet quality puppy? _____ yes _____ no (why?)

2. For what purpose do you want this German Shepherd?

_____ Personal pet (who is this person for: _______________________________)

_____ Family Pet: Give names/ages of children:

_____ Breeding (why?)

_____ Competition:

AKC/UKC obedience _____ tracking _____ agility _____ Conformation _____ Other _________________________

3. Approximately how many hours a day will your new German Shepherd be alone? (check one)

_____ 3 hours or less

_____ more than 3 hours, but less than 6

_____ more than 6, but less than 12

How many hours at a time ________________________________

4. How many people currently live at your residence? (Please list each below)

Name Relation to you Age

5. Who will have primary responsibility for the care of your German Shepherd?

6. Have you and your family discussed the pros and cons of owning a German Shepherd puppy?

Does everyone in the family want a pup? _

7. If you have children, are you willing to accept the additional responsibility of a German Shepherd puppy? Do you have time for kids AND a puppy? _ _

8. Are you willing to teach your children the proper way to handle a live animal, especially a vulnerable and rambunctious puppy? How?

9. What is your family's overall reaction to owning a dog?

What members are enthusiastic?

Unenthusiastic?

What complaints have been made?

10. Have you and your family considered that a dog lives for years?

Are you willing to make that commitment?

11. Have you considered the financial cost of dog ownership? Are you financially prepared to give your dog the routine medical care it requires and to feed it a high quality dog food?

12. Have you owned a German Shepherd or any dog before (what breeds)? How long did it (they) live, or you have them? What was the cause of death or placement with another person?

13. What is it about German Shepherd Dogs that has generated your interest in the breed?

14. What other breeds have you considered?

15. What are the four characteristics you find most appealing about a new German Shepherd? (Choose four and number the choices: 1 = BEST, 2 = 2nd BEST, etc.)

_____ active _____ calm _____ vocal _____ playful _____ independent _____ quiet _____ loving _____ high drive _____ protective _____ aggressive _____ pretty _____ dominant _____ submissive _____ large _____ aloof to strangers _____ confident _____ cuddly _____ wants to please _____ smart _____ easy to train _____ friendly to strangers Other _____________________________________________________________

16. Do you have a preference for the color of your German Shepherd?

_____ Black & tan _____ Black ______Bi-Color

Do you have a preference for the coat type?

_____Long Hair _____Short Hair _____Plush Coat

17. Adelhard German Shepherds are intelligent and active. I recommend that you take your new pup to puppy kindergarten class and to formal obedience classes after it's 6 months old. Would a formal obedience training program be something you, as a new owner, would be interested in participating in? (If NO, please provide a brief explanation)

18. What kind of work or behaviors do you expect of your German Shepherd Dog?

19. What would be your response if he/she made a mistake?

20. What amount of time and effort do you want to devote to training him/her? How serious are you about exhibiting, how competitive are you?

21. What is your definition of disciplining a dog?

What is your initial reaction to the idea of disciplining your dog?

22. How long have you lived in your current residence? ______

Please send a picture if I am unable to personally inspect.

Which of the following best describes your current residence?

_____ Own a home _____ Rent/lease a home

_____ Own/rent/lease a townhouse (multiple family dwelling)

(Please note: If you rent/lease your residence a copy of the lease and written permission from the landlord to have a German Shepherd will be required before you can purchase a Adalhard puppy.)

23. Do you have a fence? _____ yes _____ no Please send a picture.

Type of fence:

Height _______

Is the fence secure and solid?

What type of gates?

Can children open the gates?

24. What type of improvements are needed to provide a secure yard?

25. Are you willing to make the improvements?

When can you do so?

How long will it take?

26. If you have a pool, is it fenced?

27. If you have a dog run, is it secure?

28. Have you checked the yard for dangerous articles, plants or anything the dog could use to climb out, burrow under, or eat to its endangerment?

29. Are you aware of any distractions outside your yard that could plague the dog? (such as neighbor dogs, loose dogs on street, threatening neighbors, mischievous children?)

30. Can strangers gain access to your yard?

31. Have you asked yourself whether your lifestyle is so busy you might not have the time or energy to properly care for a German Shepherd puppy and raise it to be a good canine citizen? Have you carefully considered how a German Shepherd will fit into your lifestyle?

32. Is your lifestyle such that friends, relatives and children gain admittance to your home, property and car without your supervision? How?

33. Do you intend to keep the dog primarily indoors or outdoors? Please elaborate. Please send a picture if I am unable to inspect.

34. Where will the dog sleep at night?

35. What animals currently live in the household? (Please list)

Name Type of pet Sex Age How long owned? Kept where

36. Have you had any complaints about your pets? Please elaborate.

37. Does anyone in the household have any known allergies to animals?

_____ NO

_____ YES, please provide a brief explanation

38. Do you have a veterinarian you have used before and plan to use with your new German Shepherd?

_____ NO

_____ YES (please provide name/address/phone)

39. How did you find out about Adelhard German Shepherds?

_____ Veterinarian (Name _______________________________________)

_____ My website

_____ Newspaper/magazine ad (Which one)

_____ Friend (Who?)______________________________________________

_____ Other

This questionnaire was adapted from the one used by Breed Rescue Committee of the German Shepherd Dog Club of America, in the hopes that no dog of my breeding would ever have to endure abuse, abandonment or neglect. If for any reason you are ever unable to keep your Adelhard German Shepherd, I want it back.

Copy and email the completed form to me, or print it out and send it to:

Christina Hathaway

7450 SW Danielle AVE

Beaverton, OR 97008