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