Please provide us with your full name, address, phone number and email and website if you have one.
How did you hear about this litter?
Other
Occupation
Spouses occupation
-are your current pets spayed or neutered?  Also if your pets are no longer with you what happened to them?
Are there any changes in your lifestyle occuring within the next 12 months? ie:moving, job change, renovations, new baby, etc.
When are you looking to add a pet to your family?  Immediately, 3 months, 6 months, In the next year?
What type of home do you live in?
If you do not own your home have you reached an agreement with your landlord about owning this puppy?
Do you have a fenced yard for when your puppy is outside?If your answer is no how are you going to ensure the safety of your new puppy.
Where will your new puppy be spending most of his or her time when you are not at home?
Are all members of your family in agreement with getting this puppy?
If you are not at home during the day who will let your puppy outside when they need to potty?
Please provide a list of any current and past pets you have owned
Why have you decided to bring a Golden Retriever into your family?  And what traits are you looking for in your new puppy?
Please provide the names and ages of the family members in your home.
Are willing to provide regular veterinary care to your new puppy and feed a quality dog food to ensure health and well being?
Please provide the name address and phone number of the veterinarian you are or plan to use.
What plans do you have for you and your new puppy?
If your puppy is to be exculsively a family companion do you have any objections to spaying or neutering the puppy?
-if you have any objections please explain them in the space provided.
Is your preference male or female and do you have a color preference?
If your first choice isn't available are you willing to take another sex or color or wait for our next litter?
The next section is required for people who want a SHOW/Working puppy
Are you willing to achieve a CKC and/or an AKC title with your new puppy?  Have you achieved titles in the past? If so which titles and what breeds have you shown.   Please also list the registered names of the dogs you have shown.  
May we contact the breeders of these dogs for references?
Do you agree to complete all breeder required clearances before you consider breeding this puppy? Clearances required are OFA hips and elbows fair or better, eyes "normal" by a board certified Opthamologist and heart cleared by a board certified Cardiologist.
Do you plan to breed this dog?
Have you bred dogs in the past?  How many litters?

Please provide us with the names and phone numbers of two people not in your home that we can contact about you.
I understand that completing this questionnaire does not guarantee I will be accepted for a puppy.
Are you planning on taking any classes such as obedience and puppy socialization classes with your new puppy?  What activities do you like to do with your dog?
Are you willing to keep in contact with the breeder for lifetime of this puppy?  Providing updates and pictures.
Home of sound, healthy, quality Golden Retrievers that excel in competition and make outstanding family companions!
Please fill this questionnaire out completely and with as much detail as possible.  It helps us in determining if one of our puppies will fit in your family as well as matching you with your puppy.