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Your name*

City and state of residence (s)*

All initial contact is via e-mail. Please suppy your email address here so that we may contact you.*

Do you have a preference as to the SEX and/or COLOR of the dog? If so, please state preferences

Type of dwelling and do you own or rent?

Do you have a fenced yard? If not, what accomodations will you make for allowing the dog outside access?

Do you have a pool and if so, is the pool fenced?

Does anyone in your household have allergies to animals?

Are you aware of the differences between a limited and a full AKC registration?

If purchasing a companion dog, are you willing to spay/neuter your dog before the age of 18 months, or upon the advice of your veterinarian, as required in our contractt?

Are you interested in competing with your dog, be it conformation shows, agility, obedience trials or a therapy dog? If so, which one?

How active is your household? What do you expect about the energy level of a havanese?

On average, how long will your puppy be left alone per day?

Where will the puppy be kept during the day?

Where will the puppy be kept at night?

Have you ever owned a dog before?

Do you have other pets in the family? If so, please tell us a little about them. (Ages, sex, breed or type of animals, etc.)

What is your time frame for obtaining a havanese?

Pleae tell us a bit about your household. Please include ages of children (if any).

Are you aware of health concerns in the havanese breed?

If you currently have pets what is the name and phone number of your veterinarian? May we check with him/her?

Do you have any questions or comments for us? Please feel free to ask.

If you wish to make any further comments.....

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