Application – SpiritWind Shilohs

APPLICANT INFORMATION

NAME

First

Last

Email

Phone

Address

City State ZIP

How did you hear about us?

What litter are you applying for?

GETTING TO KNOW YOU

About You

(CHECK ALL THAT CURRENTLY APPLY IN YOUR HOME)

adults only

adults + small children

adults + grown children

OTHER PETS

(CHECK ALL THAT CURRENTLY APPLY IN YOUR HOME)

currently own a Shiloh Shepherd

owned a Shiloh Shepherd or GSD previously

this is my first dog

owned dogs previously, but none at the present

dog(s) are currently in the house

cat(s) are currently in the house

dog(s) & cat(s) are currently in the house

other type pets are currently in the house

ABOUT YOUR HOME

(CHECK ALL THAT CURRENTLY APPLY IN YOUR HOME)

PUPPY SPECIFICS

THE PUPPY

(CHECK ALL THAT APPLY)

PUPPY’S LIFE

WHERE WILL YOUR PUPPY SPEND THE DAY?

WHERE WILL YOUR PUPPY STAY WHEN YOU ARE AT WORK OR AWAY FROM HOME?

WHERE WILL YOUR PUPPY SPEND THE NIGHT?

HOW MANY HOURS OF THE DAY WILL YOUR PUPPY BE LEFT UNATTENDED?

HEALTH CARE & LICENSING

(CHECK ALL THAT APPLY)

veterinarian wellness visit at least once per year

keep puppy up-to-date on all vaccines

screen for heartworm & use heartworm preventative

keep puppy properly identified (tags/microchip)

abide by all state and local laws concerning dog ownership

VETERINARIAN'S NAME AND CONTACT INFO

FORMAL TRAINING, ETC.

(CHECK ALL THAT APPLY)

MORE DETAILS

BREEDER RELATIONSHIP

(CHECK ALL THAT APPLY)

agree to return puppy to SpiritWind Shilohs should you be unable to keep it

agree to provide regular follow reports on the health & well being of your puppy

REFERENCES

LIST 3 REFERENCES (2 IF YOU WOULD LIKE TO COUNT YOUR VETERINARIAN LISTED ABOVE); INCLUDE COMPLETE NAMES, ADDRESSES, TELEPHONE NUMBERS AND EMAILS

ADDITIONAL COMMENTS

LIST ANY FURTHER QUESTIONS AND/OR COMMENTS YOU WOULD LIKE INCLUDED IN THIS APPLICATION

SUBMISSION
By submitting this application, you agree to authorize the veterinarian listed above to release information to SpiritWind Shilohs. Should your application be accepted, a DEPOSIT will be required. Thank you for your interest in SpiritWind Shilohs!