Your name:__________________________________________________________________

Home phone# ________________________  email address: __________________________

Home address: (if you use a PO Box for mailing can you please also include your actual street address) ____________________________________________________________________

Occupation's (this is important as it will indicate to us how much time the puppy will be spending at home by it's self): ___________________________________________________

1)  Why have you decided that the Golden Retriever is the breed you wish to own? _________ ____________________________________________________________________________

2)  Have you ever owned a Golden Retriever before or any other breed of dog? ____________

3)  Are you looking for a young puppy ___________ or an older dog _____________________

4)  Is your preference a male ____ or female ____, light, medium or dark in coat color _______

If your first choice is not available would you be willing to take a puppy of the opposite sex or different color, or would you wait for another litter? __________________________________

5)  What is the most important thing you are looking for in a new puppy/dog? _____________ _____________________________________________________________________________

6)  What is/are the main reasons for purchasing a Golden Retriever (please check all the apply):  family companion ______  Show prospect ______ Breeding ______ Obedience competition ____ Hunting/Field work ____ agility _____ Pet therapy _____ Tracking _______

7)  Are all members of the family ready for a new dog? _______________________________ Will there by any major changes in your life style in the next year?  (example moving, marriage or a new baby?) ______________________________________________________________

8)  Do any members of your family have any type of allergies to dogs? ___________________

9)  Do you live in a house, townhouse, condominium etc. ______________________________

10)  Do you own or rent where you presently reside? ______________  If you rent have you discussed having a dog with your current landlord? ___________________________________

Landlord name and phone number: ________________________________________________

11)  Is your yard completely fenced with a secure fencing? _____________________________ If not, would you be willing to do so before bringing home a new puppy/dog or build a secure run for the puppy/dog to be in when not being safely supervised? _______________________

12)  Do you currently own any other pets? __________________________________________

13)  Age of children in the home? _________________________________________________

14)  Would someone be home with the dog during the day? ____________________________ Are you willing to crate train your new puppy? _______________________________________ If no one is going to be home during the day when the puppy requires extra attention and feedings, would someone be able to come home to feed the puppy it's lunch and let it out for exercise to keep it on a regular routine? ____________________________________________ _____________________________________________________________________________

15)  Where would the puppy or dog be housed during the day if no one is home? ____________ _____________________________________________________________________________

16)  Are you willing to take this puppy to puppy socialization classes and then on to obedience classes so that it will become an enjoyable companion and good canine citizen? ____________ Who in your home would be doing the training? ______________________________________

17)  Have you ever completed a CKC or AKC title in conformation, obedience, field, tracking or agility? _____ If yes please list ___________________________________________________

18)  Do you agree not to let this dog ride in the back of an open vehicle? _____ Do you agree never to let this puppy/dog run loose in a unfenced area unsupervised where harm may come to it? _______  Do you agree never to tie this dog up as a means of confinement? _______  Do you agree not to use a electric collar on this dog for the purpose of training? __________

19)  Have you ever had to euthanize a puppy or dog other than for old age? ________________ _____________________________________________________________________________

20)  Would you be willing to let the breeder or a friend of the breeders come to visit the puppy or dog once it is in his or hers new home to see how it is working out? _____________ ______

21)  When this puppy is purchased as a family companion and is not going to be bred, do you agree to have it spayed by 9 months if it is a female or neutered no later than 1 1/2  years of age if it is a male and submit a veterinarian certificate to the breeder as proof of surgery for her records? _________________

22)  Are you willing to contact us and keep us informed of any problems that may develop with the pup throughout  it's entire lifetime? _____________ 

Send us updates/photos periodically? ____________

If you have anymore additional information that would be helpful; to us, in placing the right puppy or dog with you, please feel free to add it below ________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ 

Thank you for taking the time to fill out this application to assist us in finding the right puppy for you.  Please feel free to call us if you wish more information or need questions answered.

If you think you are interested in adding a new family member now or in the near future, please feel free to print off a copy of this questionnaire, fill it out and mail it back to us or you can copy, cut and paste it into a email.  If you would like to come and visit us and our dogs we would be more than happy to set up an appointment for you.  It will also give us a chance to ask you a few more questions so we know exactly what you are looking for in your new puppy. 

Date: _____________________  Signature: _________________________________________

(Your can send this application to arcane@kingston.net  two ways, either copy and paste it into your email program and send that way or copy/paste into Microsoft Word, save as, and then send it as an attachment in a email )