Questionnaire

Please fill out as much information as possible! We will use these informations to try to fulfill your request!

Name of the dog you are interested:	Carla
Your name:
Home phone number:
Business phone number:
Cell phone number:
E-mail:
Address:
City:
Zip:
State:
Your age:
Age of your spouse (if applicable):
Age of your children (if applicable):
Your occupation:
Your spouse's occupation (if applicable):
You or your family's previous dog training/handling experience:
Who will be the dog's primary handler
Where do you live?	rural area suburban inner city
Your favorite activities:
Please rate your physical conditioning. Be honest!	excellent average poor
Do you or your family have any allergies? If yes, please explain.
Do you travel often? If yes, what is the average length of absence?
Has your life ever been threatened? If yes, please explain.
Do you possess firearms for self-defense?	Yes No
Do you speak a language other than English? If yes, which language?
Do you have other pets? If yes, please describe.
Briefly, explain your primary motive for purchasing a protection dog.
Please enter the code you see on the right.
We hope you do not find these questions intrusive. They are important in the K9 placement process, but do not answer any questions you are concerned with.