Swan River Goldens

Puppy Buyer Questionnaire

Date: 

Litter of Interest:   Peaches and Jake

Puppy Preference:  Male   -  Female  -   Either  - Will accept Opposite Sex
Color:    Light    Medium     Dark     No Preference

Your Name: 
  (Complete as name to be shown on Registration including co-owner if any)

Street Address: 
City:    State:    Zip Code: 

Phone Number - Home:      Work: 
E-Mail Address: 

Family Status:  Single   Married - Spouse Name:
Children Living at Home:  Yes     No
Names and Ages:

Canine Experience:  List dogs currently owned including breed, registered name, titles (if any), and call name:

List dogs previously owned and disposition of each:

Are you currently a member of the Golden Retriever Club of America?  
Yes or  No

Are you currently a member of Golden Retriever Club, Retriever Club, Obedience Club, or other dog club?
List clubs in which you are a member.

Do/will your dog(s) live:  In Home    Outside       Fenced Yard    Kennel
    Other:  

Plans for Swan River Puppy - Check all applicable:     Pet/Companion     Hunting
    Hunt Test     Obedience    Field Trial    Agility   
    Conformation
    Other 

Training:
Do you anticipate sending your puppy away to a pro for field training.  
Yes  or   No

Professional Trainer's Name: 

References:  List two persons that can verify your good character and canine experience if applicable (include phone number):

Please use the space below to add any other information you would like us to know about you or other comments: