Email: Kim Gallaway
Fill out the form by typing answers after the questions. All items marked with an asterisk (*) are required.
* Name: Spouse's Name: * E-mail Address: *Home Address: * City: * State/Province: * Postal Code:
Mailing Address: Leave blank if same as above. Street: City: State/Province: Postal Code:
* Home Telephone (with area code): Work Telephone with area code): Your Occupation: Spouse's Occupation: * Others living in your home (Name, Age, Sex): * Current number of pets: List (Names, Ages, Sex, Species, Breed, Spay/Neuter, Vaccinations):
Veterinarian Information: Vet's Name: Clinic Name: City: State/Province: Telephone (with area code):
General Questions: 1. Why are you considering an American Eskimo Dog as opposed to other breeds?
2. Have you ever owned an American Eskimo Dog? Please explain.
3. What type of dwelling do you live in?
If you rent, do you have your landlords permission to keep a dog? Yes No
4. Do you have a fenced area, yard or kennel? If so, please describe the area.
5. Where will the Eskie live & sleep? Explain fully?
6. Where do your current pets live & sleep? Past pets? Explain fully?
7. How will you exercise your American Eskimo Dog? How often? Explain fully.
8. When you must transport your Eskie, how will the dog be transported?
9. How will your Eskie be maintained when you are at work or on vacation?
10. What is your idea of proper discipline for an American Eskimo Dog?
11. What is your idea of proper and nutritious food for a dog?
*12. Does everyone in your household want an American Eskimo Dog? Yes No
*13. Will you agree to attend at least one session of obedience classes with your American Eskimo Dog if needed? Yes No
*14. Do you understand that if you are ever unwilling or unable to keep an American Eskimo Dog received through Heart Bandits, the dog must be returned to Heart Bandits? Yes No
*15 Please describe the characteristics you would like your American Eskimo Dog to have. Specify which attributes are requirements and which are merely desirable. (age, sex, size, etc.) -------------------------------------------------------------------------------- Additional Comments:
