First & Last Name 

Address 

City, State, Zip

Country

Primary Phone 

Secondary Phone 

Best time to call  

Email 

What activities do you intend to pursue with your new GSP? (Check all that apply.)

Show
Hunting
Agility
Rally/Obedience
Companion
Breeding
Other

Do you have children? If yes, please list ages.

Yes
No

Does everyone in your household want a new puppy?

Have you ever owned a dog before? If yes, what breeds?

Yes
No

Do you still have them? If not, why (death, gave away, etc.) ?

Do you have other pets? If so, please list type, ages, intact or not, etc.)

Do you have a securely fenced yard? Please describe (height, type, etc.)

How will your pup be kept when you are not at home? (at work, etc.)  

Do you intend to crate train your GSP puppy?

Yes No Not Sure

Is there a smoker in your household?

Yes No

Do you prefer...

Why do you prefer a male/female?

Are you willing to attend puppy obedience class?

Companion puppies are sold on an AKC Limited Registration and Spay/Neuter contract. Do you understand and agree with this?

[ Read About AKC Limited Registration ]

Yes
No

Are you a breeder?

Kennel Name/Web Site

Additional Comments: 

Placement Policy: 

I have read and understand the Slipstream puppy placement policy.

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