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Name:
Address:
City:
State:
Zip Code:
Country:
Email Address:
Phone Number:
3. Have you ever taken a pet to a shelter? If yes, please explain:
4. Your vet’s name and phone number:
5. Please provide two references: Name and phone number.
6. How did you decide on a Tibetan Spaniel?
7. Do you want a potential show quality Tibbie?
8. Have you competed in the show ring?
9. If you have competed in the conformation ring, how many dogs have you completed their Championships and what years?
10. Puppy preference: Male or Female
11. Which color do you prefer?
12. Do you have children living at home? If so what are their ages.
Where will the dog primarily be?	Indoors outdoors kennel both
Are you comfortable crate training your puppy?	Yes No
13. Do you have other pets? If so, how many and what breed?
How many hours would your puppy be left alone during the day or night?
15. Do you have a fenced yard? If no, how would you exercise the dog.
Do you have a pool? Is it fenced?
Have you ever had to euthanize a dog?	Yes No
If yes, please tell us why.
Are you interested in showing your Tibetan Spaniel in conformation?	Yes No Maybe
Are you interested in breeding Tibetan Spaniels?	Yes No
Are you willing to allow us, or someone we trust, to come and do a home visit at your home?	Yes No
Please list all dog clubs and/or registries that you belong to:
Are you willing to travel to pickup the puppy?	Yes No
Please include any additional information that you would like us to consider:
If we do not have anything available that meets your needs, do we have your permission to forward this application to another reputable breeder?	Yes No
You understand that all Pet Quality puppies must be neutured and registration papers will be supplied once the neuturing is verified by a Vet?

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