Name-
Street Address-
City and State
Home Phone-
Work Phone -
Email-
What are the number of people in your family? Please include children and their ages...
Which do you prefer? Male or Female
Which breed would you prefer? Pembroke, Cardigan or Toller
Why do you want a puppy?
Will you be doing any performance activities with your puppy? For example, obedience, rally, tracking, agility, therapy, etc....
What pets do you currently have?
Are your current pets spayed or neutered?
Where did you obtain your current pets?
Have any of your pets been given away or taken to a shelter? Why?
Is your yard fenced?
Where will the puppy be maintained while you are at work?
Do you plan to use a crate for this dog, if so, how will you use it?
What % of the time do you plan to keep your dog in the house? ____ Yard? ____
How active is your family?
Please feel free to email this information to me at
canuckcorgis@aol.com or you may call me at(601) 825-0408