Puppy Questionnaire and Application

Thank you for your interest in our Akitas. In order to aid us with selecting the right puppy for you, we would ask that you provide us with the following information. All information provided will be kept confidential.

(To enter information, use the TAB key to move between lines, do NOT use ENTER.)

Name:
Address:
City:
State:

ZIP:

Primary Phone:

Alternate Phone:

Best time for contact:

Email:

  1. Have you ever owned an Akita?
  2. Do you currently have an Akita, or any other dogs?
  3. If you answered yes to either of the above questions, please tell us about your dogs. How many, what are their sexes, what are their ages, are they altered or intact?
  4. Do you have any other pets? If so, what types/breeds/sexes?
  5. Why do you want an Akita?
  6. Do you intend to breed this Akita?
  7. Have you ever bred a dog? If so, please explain.
  8. Do you prefer a male or a female?
  9. What type of research have you done on Akitas?
  10. What specific color or traits do you desire? Would you consider a Long-coat?
  11. Are you aware that Akitas shed volumes of hair twice a year?
  12. Are you aware that Akitas tend to be aggressive toward other animals, especially of the same sex?
  13. What type of dwelling do you live in? (House, Condominium, Apartment, Mobile Home, etc.)
  14. If you rent, does your landlord have any issues with your having an Akita? Or, if you own your home, are you part of a homeowner’s association that would have issues with an Akita?
  15. Have you checked your homeowner’s or renter’s insurance policy to ensure there are no issues with your having an Akita?
  16. Do you have children in your home, or any that visit your home on a regular basis? If so, what are their ages?
  17. Who will be the primary care giver for the puppy?
  18. Do you have a fenced yard or dog run? What size is the area? What kind of fence and how tall? (Please provide photos of your yard, fence and dog area.)
  19. If you live in a state that experiences extreme summer or winter weather conditions, what means do you have to care for your Akita during these extremes?
  20. On average, how many hours a day will the puppy be alone?
  21. Are you interested in having your Akita participate in performance events such as obedience, agility, or confirmation?
  22. Are you willing and able to attend socialization or obedience classes with your Akita?
  23. Would you allow an in home visit by a representative of Hyojun Akitas before placement of a puppy?
  24. Please feel free to add any additional information you wish us to consider in placing one of our Akitas with you.

Signature: ______Date:

Signature: ______Date:

Return this document as anemail attachment to , or call 831-722-3121 for alternate instructions. Please be sure to include the words Akita Puppy Questionnaire in the subject line.

Thank you again – your interest is deeply appreciated.

Robyn & Larry LaCourse

HYOJUN AKITAS