Johmanda Puppy Questionnaire

If you are interested in being considered for a puppy, please fill out the following questionnaire.



Your E-Mail:
Your Name:
Address:
City, State & Zip
Phone:



  • Referred by:

  • Are you interested in a Swissy or Australian Terrier?
  • Do you prefer a male or a female? Male Female

    Why?

  • Please list names and ages of family members:

  • How many dogs have you owned in the past 10 years?

  • How long did your last dog live and what were the circumstances of its’ death?

  • Have you ever returned a dog to its’ breeder and if so, what were the circumstances?

  • What are the qualities that attracted you to the breed you have chosen?

  • What activity level do you expect this breed to be:
    very high high moderate low

  • Are you aware that these dogs may take longer than average to housetrain?
    Yes No

  • Is anyone in household allergic to dogs?
    No Yes Don't know

  • Please describe your home and living situation (urban, rural, apartment, condo or house):

  • Please describe your yard (size, type of fencing, etc.):

  • Where will the puppy be kept during the day?

  • Will he/she be left alone during the day and if so, for how many hours?
    1-3 3-6 6-9

  • Will someone be available to feed and exercise him/her during the day? Yes No

  • Where will puppy sleep at night?

  • Do you plan to use a crate for house training?
    Yes No

  • What is your past experience with regard to raising and training dogs?

  • Do you agree to attend Basic Obedience classes?
    Yes No

  • Are you interested in show/breeding quality or a companion dog?
    show/breeding quality companion

  • Do you agree to spay or neuter a companion dog?
    Yes No

  • Have you shown a dog to its Championship?
    Yes No

  • Are you interested in participating in performance events such as packing, herding, obedience, rally, drafting, weight pull, agility, tracking, earthdog, or Terrier Racing with your dog?
    Yes No

  • Do you agree to spay or neuter a show/breeding quality dog if it does not receive passing final clearances on OFA hips, elbows, shoulders or receives an abnormal eye CERF?
    Yes No

  • Please list name, address and phone number of the veterinarian you will be using for your puppy:

    Please list names, addresses and phone numbers of three personal references:

    Reference 1:

    Reference 1:

    Reference 1: