Please provide the following contact information:

Name(s):

Street Address:

Address (cont.) :

City/Town:

State/Province:

Zip or Postal Code:

Country:

Home Phone Number:

E-mail:

What are your reasons for wanting a Boykin Spaniel?


Have your ever owned a Boykin Spaniel?
Yes      No

If yes, please state from whom you purchased your dog.


Please select the area in which you are most interested: (check all that apply)
Show
Pet
Obedience
Agility
Field


Is your preference for a:
Male
Female
No Preference


Do you prefer a:
Puppy
Adult
No Preference


If a puppy were not available, would you consider an adult?
Yes      No


If you currently have another dog or dogs, please list their breed and age.


Do you have a fenced yard?
Yes      No


How many adults occupy your household?   

How many children in your household? Please list ages.


How many hours per day with this dog be left alone? Please explain.


Do you plan on taking this dog to a puppy kindergarten or adult obedience class?
Yes      No


A veterinarian or professional groomer is an excellent reference. If you have one or both, please list their name and number so that they may be contacted.


How did you hear about us? Please list the name and number of the person so that we might thank them for the referral.


Thank you for taking the time to complete this questionnaire and for your interest in a Carolina Kennels Boykin Spaniel.