BOYERO Perm. Reg’d ~ Bouvier des Flandres

Thank you for your interest in our dogs. Please take a few minutes to fill out our easy form to help us determine if a Boyero puppy is right for you. These questions will help us be sure that you will be getting a puppy that you are happy with and help us the right puppy / dog for you. It is also to help me be assured that my puppies will be going to good homes. All information is confidential and used only by us. Thank you for your cooperation and help in answering our questions.

Serge Bilodeau /

Name : ______

Street address :

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Phone #Home ______Work ______

Fax ______E-mail ______

Best time to call, if we have to reach you ? ______

How were you referred to us ? ______

PUPPY INFORMATION

Are you interested in a...Puppy Adult dog Male Female No preference 
If that sex is not available would you consider the other ? Yes No 

Colors desire...Black Brindle Fawn Grey No preference 

Why are you interested in obtaining one of our Bouvier des Flandres ?

Breeding Companion HerdingObedience Show 

When are you looking to purchase a puppy ? ______

What qualities do you like in the Bouvier de Flandres ? ______

What don’t you want to find in an Bouvier des Flandres ? ______

DOG INFORMATION

Is this your first Bouvier des Flandres ? If no, from whom did you get that Bouvier ?______

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Have you previously owned dogs ? What breeds ? ______

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Do you presently own a dog or other animals ? ( breed, age, sex and spay/neuter status) ______

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Have you ever given a dog up to a shelter, pound or rescue group, if yes please explain ? ______

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Have you ever had to euthanize a dog ? If so, why ?______

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Have you ever bred a dog/dogs before? If yes please elaborate. ______

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YOUR FAMILY INFORMATION

Are you ?Maried Single 

Number of adults in your household ? _____Ages ?18-3030-65 65 & +

Do you have children ? ______Ages ? ______

Occupation of adult(s) in family ? ______

Others in household who will have contact with the dog ? ______

Does anyone in your family have allergies to dogs?YesNo Don’t know

Is everyone in you family committed to getting an Bouvier? If no, please explaine ?YesNo

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Do you have a fenc eyard ? ______

Do you live in ?House Apartment Urban Suburban Rural 

YOUR COMMITMENT

Where will the dog stay during the day ? ______

Where will the dog stay during the night ? ______

Where will the dog be when no one is home ? (loose or crated, confined to kitchen, basement, garage, yard, kennel or other)

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Are you committed to take care of this dog for its lifetime ? ______

Are you committed to have this dog spayed/neutered ? ______

Are you be willing to go to obedience classes ? ______

Is each member of the household committed to disciplining the dog ? ______

Do you have a veterinarian? If so please give name and address for a reference ? ______

Are you willing to follow the Health Guidelines supplied by Boyero Kennel regarding shots, exercise and feeding ?

Yes No May be 

If no or maybe please explain: ? ______

Are you willing to stay in regular contact with Boyero Kennel for the life of the dog and provide updates ? ______

Why a Boyero Bouvier ?

OTHER CONTACTS MADE

Have you spoken with any other Bouvier breeders? If Yes, please list them below:

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Are you currently on the waiting list for any other litters?YesNo

Were you referred to US by anybody in particular ? If Yes, please list them below:YesNo

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Are you at all interested in being contacted about Rescue dogs or older dogs needing placement if we should come across a dog
that we feel would suit your needs ?

Yes No May be 

Please add any other information you wish us to consider in placing one of our Bouvier des Flandres with you. We would appreciate if you would give us a little insight into the expectations you may have for this new addition to your family.

Thank you again, your interest is deeply appreciated.

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REFERENCES

Please list several (at LEAST 3) references (veterinarian, person active in dogs or close acquaintance preferred). Please include a phone number for each reference (and e-mail address if possible):

Reference 1:______

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Reference 2:______

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Reference 3:______

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Reference 4:______

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Signature: ______the ______

Completing this form does not guarantee
a reservation or placement of puppy!!

Serge Bilodeau /