Haldane Wheatens A Breed Above the Rest
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Haldane Wheatens
Haldane Wheatens
Haldane Wheatens - Our Litters

It is very important to us that we place each of our puppies in a home where the puppy will be a cherished member of the household. In order to do so, we know that it is important to match each puppy to the family's needs. Your response to this questionnaire helps us to know you and what you are looking for in your Wheaten. Please fill out as much of the questionnaire as possible.


Name(s):  
Address:  
City, State:  
Zip:  
Home Phone:     Work Phone:  
Fax:     Email:  


Household and Community:
Members of household, with children's ages and adults' occupations:

Name & Relation: Adult Occupation: Age:
What are the family's favorite forms of recreation?
Is someone home during the day?
Yes   No
If no, what is the longest time away?
You live in? House   Townhouse   Apartment/Condo  

Own or Lease?
Do you have a fenced yard?
Yes   No
Where do you intend to keep your Wheaten?
Indoor   Outdoor
Do your neighbors have dogs?
Yes   No
If yes, what type or breed?
Does your community or homeowners' association have any restrictions regarding dogs?
Yes   No
Does your city or county have a spay/neuter requirement for dog ownership?
Yes   No


Routine, Care and Ownership:
Have you previously owned a Wheaten?
Yes   No
What other breeds of dog have you owned?
What happened to your other dogs?
Do you currently have other pets?
Yes   No
If yes, specify type of pet, age and sex:
How/where would the dog spend the day as a puppy?
How/where would the dog spend the day as an adult?
Where will the dog sleep?
For what periods of time would the dog be left alone?
Are you able to spend more time with a puppy when it first goes home?
Do you currently have a "family" veterinarian?
Yes   No
If yes, please state name and telephone number:
Are you aware of the normal recurring expenses to own a pet Wheaten (medical, grooming, supplies, training, etc.)?
Yes   No
Are you willing to provide these?
Yes   No
Are you aware of Wheaten grooming needs?
Yes   No
Do you need more wheaten grooming information?
Yes   No
How do you plan to manage the routine care and grooming of a Soft Coated Wheaten Terrier?
Who will be responsible for combing and trimming toe nails on your wheaten every week?
Are you willing to attend puppy kindergarten class?
Yes   No
Do you plan on attending obedience training with your Wheaten?
Yes   No
Are you willing to crate train your puppy?
Yes   No


Choices, Goals and Experience:
Do you have a preference as to male or female puppy?
Male   Female

Why?
Why do you prefer a puppy over an adult dog?
Do you want a Wheaten as a (check all that apply):
Companion/Pet
Show Prospect
Obedience Prospect
Agility Prospect
Protection Animal
Therapy Prospect
Any experience in showing, obedience training or breeding?
Ever attended a dog show or obedience trial?
Yes   No
Are you willing to have your puppy spayed or neutered?
Yes   No

If no, please explain:


Referrals:
How did you become interested in a Soft Coated Wheaten Terrier?
How were you referred to us?
Additional information you would like to give us.
I hereby certify that all the information contained on this application is true and correct. I understand that I will be required to sign a Purchase contract. This application will become part of the agreement and any misrepresentation in this application will constitute a breach of the Conditions of Purchase.

Signature
Entering your name and today's date will be accepted as a signature.

Name:
Date: