Please provide the following contact information:

Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Home Phone
E-mail

What is your occupation?

What is your spouse / partner's occupation?

Are you a member of:

All Breed Kennel Club/Obediance Club
Regional Newfoundland Club
Newfoundland Club of America

          Name of Kennel Club

          Name of Regional Newf Club

Do you:

Own a home
Rent a home

          If renting, does your landlord allow large, hairy slobbery dogs?

          What is your landlord's contact info?

If you live out of the area are you willing to travel for an interview in person?

Yes
No

Are you willing to travel to pick up your pup?

            Yes

            No

What attracted you to the Newfoundland breed?

How did you hear about Capriccio Farm Newfoundlands?

Do you have a gender preference for a pup?

Male
Female
Either

What do you expect to do with your puppy? choose all that apply.

Family Pet      Drafting/Carting  Agility           Obedience       
Show              Tracking            Water Work        

          Are there other Newf activities you are interested in?

Have you owned Newfoundlands or other breeds in the past?

Yes
No

Do you currently own a Newfoundland or other breed of dog?

Yes
No

          If you do own another dog, what breed and what activities do you do with your dog(s)?

Have you ever had to re-home, surrender to a shelter or euthanize a dog/Newf?

Yes
No

          If so, what were the circumstances, and where and in what county/state did this occur?

          Who was the breeder of the dog, and did you attemp to contact him/her? please give a detailed account.

Who is your veterinarian, or if you don't currently have a dog, who was your veterinarian in the past?

          Veterinarian's phone number?

Do you have a yard, and is it securely fenced?

Yes
No

Where will the puppy/dog be kept the majority of the time?

Do the adults in the family work away from home?

Yes
No

          If so, where will the puppy/dog be kept while away at work?

What arrangements will be made to make sure the puppy will not be isolated for long periods of time?

Do you have any children?

Yes
No

          If so, what are there ages sex?

Who will be the primary caretaker of the puppy/dog?

Will you be adding a new family member within a year of getting your puppy?

Yes
No
If so, I would direct you to Newfoundland Rescue, as it is extremely difficult to give both a human baby and a Newf baby the attention that each of them need and deserves.  An older dog would be a much better way to go if you are absolutely set on getting a Newf within the time frame of a new human addition.

Are you willing to have me, or my designee make a home visit?

Yes
No

Please supply references as to your suitability to owning a large breed dog.

Do you have any additional comments?