Nikita - Information Request Form

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E-Mail :
Name :
Region :
Type of Residence : single House in the city, appartment in the city, single house in the country, other (describe)
Person living in the house :	Adult Working outside Children
Children age :
Person who will be in charge of the dog :
Back yard type : securely fenced, unfenced, no back yard, other (describe)
Where will you keep your samoyed :
During the day :
At night :
Experience with dogs : first dog, own before (race)
Why a samoyed ?
What do you know about the samoyed ?
Why do you think that a samoyed is for you ?
Why did you choose our Kennel ?
Comments, questions, contact information, ...