Date:

Personal Information

First Name:
Last Name:

Address:

City:   Prov/State:   Postal Code:

Phone (home): -  Phone (work): -

Long Distance Calls Will Be Returned Collect

Email:

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What you are looking for

1. What is your time frame for obtaining a Dog?

2. Are you prepared for/Do you know the effort involved in housebreaking a Dog?

Yes

No

3. Are you prepared for/Do you know that the care and grooming of an Affenpinscher?

Yes

No

4. What Sex would you prefer: Male  Female

• Would you consider the Opposite Sex?   Yes

5. Would you be interested in/consider "showing" or having the dog "shown" to obtain its championship?

Yes

No

6. Do you understand that you will be required to sign an Agreement where you will agree to maintain the health and well-being of the Affenpinscher; where you may be required to provide proof of such; that if the dog is being placed as a pet, you will not be able to breed the Affenpinscher and will be required to spay/neuter the Affenpinscher; and where the breeder may retain an ownership interest in the dog (i.e. may remain as a co-owner)?

Yes

No

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Home Environment

1. Number of Household Children:   Ages:

2. Other Animals/Type/Ages:
    

3. Where will the Dog stay during the day?

4. Where will the Dog stay at night?

5. When you travel out of town where will the Dog stay?

6. What are your thoughts on the use of a Crate for your Dog?

7. What are your Expectations / Concerns about getting an Affenpinscher?     

8. Briefly explain Why you believe You would Provide a Great Home for an Affeninscher:     

9. Is this your first Dog? Yes  No    If no, How long ago/ Breeds/ What happened to the Dog(s)?
    

10. Your Home is a/an House Apartment Condo .

11. Your Neighborhood is Urban Rural .

12. Fenced Yard? Yes  No    Fence Type/Height:
**Not having Fenced Yard is not necessarily a reason to not be considered for a dog.**

13. Are you planning on relocating in the future?   Yes If yes, what plans have you made for the Dog during the move and afterwards?
    

14. If you are no longer able to care for a Dog, who would take over the care?     

15. Estimate your expected Monthly Grooming expenses:

16. Estimate your expected Annual Vet Care expenses:

17. What types of items do you expect to purchase to maintain an Affenpinscher?
    

NOTE: Providing this application is not an Offer to sell a dog. Also, submission of an application is not an Acceptance of an Offer and does not in any way guarantee that you will be considered for a dog or that one will be sold and placed with you.