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Your name:
Type of residence(house, condo townhouse etc):
If you rent have you discussed having a dog with your landlord:
Is your yard completely fenced:
Are all members of your family ready for a dog:
Please list your pet types and ages:
Have you ever had to euthanize a pet due to anything other than old age:
If so please tell us the circumstances:
Are you willing to keep us informed of any problems which may develope with the pup throughout it's lifetime:
We have thoroughly read and understand the above questionnaire and feel that I/we are ready to accept the responsibility of a new puppy/dog. I/we agree to provide adequate health care for our new pet and a loving and playful environment and necessary discipline. I/we agree to keep our puppy/dog at an appropriate weight for the health of our pet:
How did you hear about our dogs?
Spouse's name:
Home address:
Do you own or rent:
Landlord name:
Landlord contact number:
What type of fencing:
Have you ever owned a Golden Retriever or another breed of dog before:
Do you prefer a male or female:
Do you prefer a puppy or young adult:
How did you decide on a Golden Retriever:
Do any of your family members have allergies to dogs:
Will someone be home during the day with the puppy:
If not, is someone available to feed puppy noon time meal:
Are you willing to crate train your puppy:
Are you willing to take puppy to socialization/obedience classes:
Where do you plan to attend classes:
Do you currently own other pets:
Do you understand that you would be purchasing this puppy on limited registration and do you agree to have this puppy spayed or neutered:
Are you willing to have the breeder or a friend of the breeder come to your house to visit the puppy or dog in it's new home:
Are you willing to have your puppies hips xrayed by 24 months old to help us with our breeding program:
Name address and phone number of your veterinarian:
Do you agree to not let this dog ride in the back of an open vehicle:
Do you agree to never tie this dog/puppy up as a means of confinement:
Do you have children?  If you do please provide their names and ages:
P.O. Box 295
Maple Valley, WA 98038
Randy and Julie Schepper
Dave and Sally Maryatt

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