Name(s) (Please indicate all names if joint ownership):

Address of Principal Owner (where dog will reside):

Postal/Zip Code:

Home Phone:

Office Phone:

Fax:

E-Mail Address:

How many family members and others are there in your home?

Adults:

Children and Ages:

Do you have a fenced yard?

Please provide a brief description of other animals in your household.

Why do you wish to buy a dog at this time?

Why do you want a Sheltie as opposed to any other breed?

Do you have a preference for colour? Will you accept other colours? (Rank)

No Preference___ Sable___ Sable merle___ Tri___ Blue merle___

Bi___ Bi-blue___

Do you prefer a male or female?

Male_____ Female_____

Please describe the “personality” you are looking for in a Sheltie.

Have you had a Sheltie before? If yes, please describe him/her and provide CKC information. If more than one previous Sheltie, please indicate how many and describe the last one.

Full CKC Name: ______________________________________________________

CKC Registration #: ____________________________________

What experience do you have with dogs, specifically with raising puppies?

During a typical day, how many hours would the puppy be left alone?

Week-days:

Week-ends:

Do you have a regular puppy/dog sitter for times when you are away (holidays, etc.)?

Do you have any life style traits that may impact upon the caring for a Sheltie? e.g. are you out of town a lot?

Please provide the Name and Telephone Number of your Veterinarian.

Veterinarian’s Name: ___________________________________________________

Practice Name: _______________________________________________________

City/town: ___________________________ Telephone #: ___________________

Are you a member of any Dog Clubs or Associations? Do you plan to be?

CKC Membership # (if applicable)__________________________

Do you plan on participating in dog-related activities?

Conformation Shows____ Sanction Matches_____ Obedience Trials_____

Test Matches_____ Agility_____ Flyball_____ Canine Good Citizen_____

Obedience_____ Other____

Do you plan to use this puppy in a breeding program? If yes, please describe your experience in breeding Shetland Sheepdogs.

Have you ever bred puppies of any other breed? If yes, please describe your experience and indicate the breed(s) involved.

Have you read any books on Shelties or about dogs in general?

Is there any other information you can provide us that you think may be helpful?