Name*:
Email Address*:
NOTE: Due to some security protection issues, if you are using an @aol.com or @yahoo.com address, please use yourname@calibershilohs.com in the email address section and note your correct email address in the comment section of this application.
Address:
City:
State:
Zip:
Country:
Home Phone*:
Work Phone:
Occupation:
How did you hear of us?
How did you learn about Shiloh Shepherds?
Please take your time answering the following questions; answer all
the questions. Give us as much information as possible; if you need
more room,
please use the comment section and label with the correct question number.
1. In what type of housing do you reside?
Apt/Condo
Single Family
Townhouse
2. Do you live:
in Town/City
in the Country
in the Suburbs
on a Farm
3. 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:
4. Do you have a fenced yard?
yes
(in feet)
no
Are you able to leash walk your dog at least 4 times daily for necessary
functions?
yes
no
If no, why?
5. My household consists of the following number of:
Adults
Children
dogs
cats
other
My children's ages:
Adult ages:
My dogs are (list breed, age, sex, intact or spayed/neutered):
6. I have owned
dogs in the past
7. My dogs were:
given away
killed in accidents
died of old age, euthanasia
other (please expain)
because:
other reasons:
8. Does anyone in the household have allergies?
no
yes, what type?
9. Do you expect to have children?
yes
no
10. Do you have a person living in the household that is
Elderly
Handicapped
has special needs
11. I am interested in a pet and plan to spay/neuter:
yes
no
12. I am interested in showing and/or breeding:
yes
no
13. I am interested in training my dog in:
Obediece
Agility
Search & Rescue
Therapy/Assitance
Schutzhund
Herding
Other
14a. My dog will spend most of his/her time during the day:
in the house
in a fenced yrd
in a kennel run
on a leash/chain
loose
14b. My dog will spend most of his/her time at night:
in the house
in a fenced yrd
in a kennel run
on a leash/chain
loose
15. The temperament I expect from my dog, as per the following possibilities
would be:
The mailman knocks at the door with a package delivery, I want my dog
to:
bark, then make friends
bark, and not make friends
bark and chew him up
other (please explain)
other, please explain
16. I would like a:
male
female
either
17. I would like a:
Plush coat (long hair)
Smooth coat (short hair)
Either
18. I would like a:
Sable
Dual
Bi Colored
White
Black
Not Sure
Doesn't matter
19. Which family member will have the major responsibility for the
dog?
20. How many hours a day would the dog be left alone?
hours
21. If necessary, are you willing to crate train your Shiloh?
yes
no
22. Do you agree to return your Shiloh to us if you
are unable to keep it?
yes
no
23. Are you willing to keep the dog up to date on all of its vaccines,
screen for heartworm, use heartworm preventative and use flea preventative?
yes
no
24. Are you willing to:
pay shipping charges on this dog
pick up personally
25. Are you willing to have your dog seen by a vet at least once a
year?
yes
no
26. Are you willing to feed your dog only a high quality food?
yes
no
27. Are you willing to license your dog, keep it properly identified
and abide by your state and local laws concerning dog ownership?
yes
no
28. Are you willing to stay in contact with us and keep us up to date
on your puppy's growth, health, and temperament and provide us with
photographs of your Shiloh as he/she grows?
yes
no
29. Who is your Veterinarian?
Name:
Address, City, State, ZIP:
Phone Number:
30. Please list 3 references (2 if you would like to count your Veterinarian).
Please include complete names, addresses and telephone numbers:
a.
b.
c.
By submitting this application, I (we) authorize the Veterinarian listed
on this application to release information to High Caliber Shilohs.
Applicant's name:
Date:
Which breeding are you interested in, and why did you choose this breeding?
Any further questions and/or comments you may have can be included
with this application. Please make your comments below: note: if you are using an @aol.com or @yahoo.com address, and you used yourname@calibershilohs.com in the email address section above, this is where you would note your correct email address.
Please contact us for
further information and details regarding the deposit.
Thank you for your interest in High Caliber Shilohs.