VIVA HAVANESE

318 Old State Road

Binghamton, N.Y. 13904

E-mail:

Please assist me to choose the puppy that is the best possible match for you and your family by answering the questions below and returning this form to me as soon as possible. Of course, all of our puppies are intended to have sound bodies and temperaments and will conform as closely as possible to the A.K.C. standard but just as each child has a different personality, so do puppies. It is my wish that each puppy that I produce go to the home where both the owner and the puppy will have the best relationship. My puppies live in my home with me until they leave for their new homes. I am able to observe the puppies under many different circumstances and my thirty years of experience with breeding enables to match each puppy to the correct home very accurately.

1) Have you owned dogs in the past? _____

If yes: what happened to them? ______

2) What is the primary reason that you have decided to purchase a Havanese?

______

3) Are your familiar with the breed? _____

4) Have you previously owned a Havanese?

If yes:

a) What do you feel were the most positive traits of your Havanese? ______

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b)  What negative feelings do you have regarding the breed? ______

______

5) Do you have other pets? ______

If yes:

a) What are they? ______

b) How long have you had them? ______

5) Please tell me about your family:______

______

a) How many people reside in your home? _____

b) Who will be the principal caregiver for you Havanese? ______c) Will your Havanese be living with children? ______

If yes:

What are the ages of the children? ______

Are these children use to having pets? ______

6) Do you have a fenced yard for your Havanese? ______

If no:

a) Do you live in a remote area where your dog will be allowed to run loose? _____

b) Do you intend to arrange to tie your Havanese when outdoors? ______

c) Will you walk your dog on a lead? ______

How many times per day will you be able to walk your Havanese? ______


7) How much time will your Havanese be left alone as a puppy?

a) ___ Someone is at home nearly all of the time.

b) ___ We work away from the home but will be able to come home at lunchtime or will arrange to have someone exercise the puppy during the day while we are away.

c) ___ The puppy will have to stay alone during the day while we are at work.

d) ___ I am able to take my puppy to work with me.

e) ___ Other – Explain:______

8) How often to you plan to brush your Havanese?

a) ___ daily c) ___ as needed

b) ___ weekly d) ___ I plan to let a groomer do it.

9) How active do you want your puppy to be?

a) ___ very active c) ___ very quiet and cuddly

b) ___ moderately active d) ___ not important

10) Do you have a preference regarding the sex of your puppy?

a) I prefer a ______puppy but will accept what is available first.

b) I must have a puppy of the ______sex and am willing to wait until one is available. How long are you willing to wait for a Havanese puppy? ______

11) Do you have a size preference?

a) ___ I prefer a smaller Havanese (preferably under 10 pounds)

b) ___ I prefer a larger Havanese (10+ plus)

c) ___ Size is not important to me.

12) Do you have a preference regarding the color of your puppy? If so please list in the order of importance to you.______

13) What other qualities would you like your puppy to possess (Please list in order of importance to you?)

______

______

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14) Is there anything else that I should be aware of when choosing the correct puppy for you?

______

______

______

Thank you for taking the time to fill out this information. I will do my best to choose the puppy that is close to what you want as possible and that will fit the desires of your family.

Ruthellen

Name: ______

Address: ______

Telephone # ( ) ______

E-mail address: ______

Date: ______