Form

Name of the person in charge of the dog : *

Phone number : *

E-Mail address : *

Age : *

Region where you live : *

Type of house : *

single House in the city, appartment in the city, single house in the country, other (describe)

Describe your backyard or your possibilities to do exercise with your dog : *

securely fenced, unfenced, no back yard, other (describe)

Number of person living at home : *

Adult, Children

Number of person working outside full time : *

Where will mostly live your Samoyed ? *

Is it your first dog ? *

Yes

No

If no, how many dogs do you have before? Breed ?

Why do you want a dog ? : *

Describe your experience and knowledge about puppy’s education : *

Are you ready to invest time and money in the education of your puppy ? *

Yes

No

When will you be ready to adopt your Samoyed ? : *

Now

In 3 months

In 6 months

In more than 6 months

Why do you want a Samoyed (what do you know about the breed) ? : *

Why did you choose our Kennel ? *

Will you sterilize your dog ? : *

Yes

No

Validation :

If you are human, leave this field blank.