* 1. Your Name: * 2. Your Address: * 3. Home Phone: 4. Work Phone: * 5. Email: 6. How long at this address? 7. Referred by (how did you find out about Sassenach): 8. Have you met any Gordon setters in person or read any information on the breed? * 9. Type of home: House Apartment Condo Acreage Farm 10. Do you own or rent your home? If renting please provide the landlord's name and address (Your landlord will be contacted regarding pet policies): 11. Who will be the primary care giver? 12. Where will the puppy sleep at night? 13. Is anyone home during the day? If no where will the puppy be confined? * 14. Will there be someone to feed and exercise the dog during the day? Yes No 15. On average, how many hours will the puppy be on its own during a 24 hour period? * 16. Have you owned a dog before? Yes No 17. What breed? 18. How long did you have the dog, and what were the circumstances of its death? * 19. Do you have any other animals? Yes No 20. Who is your Veterinarian (name, phone number and address)? * 21. Do you have any children, grandchildren? Yes No 22. If yes, what are their ages? * 23. Does anyone in your family have allergies to animals? Yes No 24. If yes, to what and how severe? * 25. Are you interested in a male or female puppy? Male Female 26. What age do you want your puppy to be? * 27. How active do you expect a Gordon Setter to be? Very High High Moderate Average Low 28. Do you have a fenced yard or dog kennel? 29. How many hours a day will the puppy be outside? * 30. Have you house trained a puppy before? Yes No * 31. Do you believe in dog crates? Yes No * 32. Will you attend training classes? If yes, please provide trainer name and address. * 33. What activities or competitions are you interested in? Conformation Obedience/Rally Field Companion Other 34. If you checked 'Other' above, list them here: 35. Have you ever returned a pet to a breeder, taken to the pound or given away? If so, what were the circumstances? 36. Are you interested in showing the dog in a conformation ring? Yes No * 37. Have you shown a dog to its championship before? Yes No * 38. Have you groomed a setter for competition before? Yes No * 39. Have you completed any performance titles with previous dogs? Yes No * 40. Do you intend to breed the dog? Yes No * 41. Do you understand the difference between a non-breeding registration and a full registration? Yes No * 42. Do you understand why a breeder requests co-ownership on the dog? Yes No 43. Please provide names and contact information for two references: 44. If this is your first dog and references are not possible, are you willing to allow the breeder to visit your home (or have someone do a home visit if you are at a distance)? This helps determine the suitability of a Sassenach puppy to your situation. 45. Additional information you wish to provide: