Puppy Application

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Name:*

Email Address:*

Address:

City: State: Zip: Country:

Home Phone:* Work Phone:

How did you hear about us?

In what type of housing do you reside? Apt/Condo Single Family Townhouse

Do you live: in Town/City in the Country in the Suburbs on a Farm

Do you own rent

If you rent, does your landlord permit dogs? yes no

Would you permit us to contact your landlord? yes no

Landlord's name and phone number:

How did you hear about Shiloh Shepherd Dogs?

Do you have any other pets in the household? yes no

Any other dogs? yes no , If yes, sex and breed of dog

How many people in your family? Adults Children

Do you have a fenced yard? yes (in feet) no

If you have owned dogs in the past, how long did they live with you? dogs for years

Are you willing to crate train your Shiloh? yes no

Are you willing to have your dog checked by a vet at least once yearly and, as needed, to keep all immunizations up to date along with heartworm and/or flea preventative?

yes no

Who is your Veterinarian?

Name: Phone:

Address, City, State, ZIP:

Are you interested in showing and/or breeding? yes no

Male or female pup? male female either

Smooth or Plush coat? Plush coat Smooth coat Either

Any special color? Sable Dual Bi Colored White Black Not Sure Doesn't matter

Will you be training your dog in: Obediece Agility Search & Rescue Therapy/Assitance Schutzhund Herding Other

Where will the dog spend most of the time? in the house in a fenced yrd in a kennel run on a leash/chain loose

Please list 3 references (2 if you would like to count your Veterinarian). Please include complete names, addresses and telephone numbers:

a.

b.

c.

Any further questions and/or comments you may have can be included with this application. Please make your comments below: