Valkyrie Kennels

Name

Email address

Phone number

Mailing address

Date

How were you referred to us? (if friend please provide in reference section)

Internet
Breed club
Friend
Other

How many members does your family have and what are the approximate ages?

What are their occupations? Hours of work?

Is someone available throughout the day to exercise a puppy?

Yes
No

Do you own your home, rent or reside with others?

Own
Rent
Reside with others

If you rent, has your landlord agreed in writing to allow you to have a dog on the premises?

Yes
No

Is your residence rural, suburban or in the city?

Rural
Suburban
City

How long have you lived at your current address?

Do you have a securely fenced yard?

Yes
No

If not, how do you plan to keep your puppy from roaming/being stolen?

Do you have a pool?

Yes
No

If yes, is it fenced in?

Yes
No

Where will the puppy live?

Who will be the primary caregiver to the puppy?

Does anyone in your family have allergies?

Yes
No

Is there someone in your family who does not want a dog or dislikes dogs?

Yes
No

Have you ever owned a Lagotto Romagnolo before?

Yes
No

If yes, when? For how long?

Who did you obtain it from?

What happened to it? If deceased, how did it die?

Have you ever owned other breeds of dogs?

Yes
No

If so, which breed(s) and what happened to them?

Are there any other dogs in residence in your family right now?

Yes
No

If so, which breeds and what are their approximate ages?

Do you have cats?

Yes
No

If yes, how many and approximately how old are they?

Do you have a regular veterinarian?

Yes
No

If yes, please list name, address and phone number.

Are there likely to be any major changes in your lifestyle in the near future? (such as moving, pregnancy, care of an elderly relative etc.)

Yes
No

Do you plan on using a crate for your Puppy?

Yes
No

If no, why not?

Which of the following activities are you interested in pursuing?

Conformation
Obedience
Agility
Pet Therapy
Other

If requesting a Show / Performance puppy please briefly summarize your experience.

Which are you primarily interested in?

Male
Female

Will you accept a puppy of the opposite sex, if your first choice is not available?

Yes
No

Are you willing to wait until the next available litter should a puppy not be available from the most current litter?

Yes
No

What characteristics are you looking for in a Lagotto? (eg: size/colour/activity level)

Quite often we have a waiting list for puppies & it's unlikely that we'd have one available immediately. How long are you prepared to wait for the right puppy?

Are you prepared to have a pet/companion Lagotto spayed/neutered?

Yes
No

If not, why not?

Are you willing to attend a minimum of one set of obedience classes?

Yes
No

Are you willing to return the dog to the breeder should some unforeseen circumstance arise and you would no longer be able to keep the dog?

Yes
No

In your own words, please describe why you want to get a Lagotto Romagnolo.

Name, address and phone number of at least two references