APPLICATION FOR PLACEMENT OF SPECIAL EMANUEL HOMESTEAD GOLDEN PUPPY CLIENT INFORMATION SHEET 2017-2018 FAX: 860-924-6660 [ONCE I HAVE RECEIVED YOUR COMPLETED APPLICATION, I WILL CONTACT YOU EITHER BY EMAIL OR BY PHONE TO DISCUSS YOUR ELIGIBILITY FOR AN EMANUEL HOMESTEAD GOLDEN RETRIEVER PUPPY!!!!! I LOOK FORWARD TO TALKING WITH YOU FURTHER & GETTING TO KNOW YOU BETTER!!!!!!!! BY COMPLETING THIS APPLICATION, THE INFORMATION WILL BE USED TO HELP MATCH JUST THE RIGHT PUPPY WITH JUST THE RIGHT FAMILY!!] DATE CLIENT CALLED CLIENT EMAILED CLIENT APPOINTMENT/REVIEW DATE/TIME PRICE QUOTED FOR MALE FEMALE WILL CLIENT SEND OR LEAVE DEPOSIT? NAME ADDRESS PHONE CELL EMAIL ADDRESS: NUMBER OF CHILDREN AGES OCCUPATION SPOUSE/PARTNER OCCUPATION
PAGE 2 HAVE YOU HAD A PUPPY BEFORE? YES WHAT BREED/S NO IF YES, WHAT KIND? HOW LONG AGO? DO YOU CURRENTLY HAVE A GOLDEN? MALE/S# NEUTERED? FEMALE/S# SPAYED? OTHER DOG? HOW MANY? WHAT BREED/S? SPAYED? NEUTERED? IF YOU HAVE OR HAD THE JOY OF ONE OF MY 'EMANUEL HOMESTEAD GOLDENS' WHAT LITTER (PARENTS) & DATE HOW DID YOU HEAR ABOUT ME & MY DOGS? REFERRED BY ARE YOU INTERESTED IN A MALE? FEMALE? SIZE BUILD COLOR FEATURES WHEN [WHAT TIME FRAME/APPROX. DATE] ARE YOU LOOKING TO HAVE YOUR NEW PUP/S JOIN YOUR FAMILY & YOUR HOME? WHAT IS IT THAT HAS LED TO YOU & YOUR FAMILY TO WANTING TO OWN & RAISE ONE OF MY SPECIAL EMANUEL HOMESTEAD GOLDEN RETRIEVERS? WHAT ARE YOUR EXPECTATIONS OF YOUR NEW GOLDEN? HAVE YOU SPENT SOME TIME READING THROUGH THE EXTENSIVE INFORMATION & MATERIAL ON MY WEB SITE? THOUGHTS/COMMENTS?
PAGE 3 HAVE YOU RECEIVED MY INFORMATIONAL EMAILS WITH SEVERAL ATTACHMENTS & BEEN ABLE TO TAKE THE TIME TO READ THROUGH THIS INFORMATION PROVIDED TO HELP ANSWER MANY OF THE QUESTIONS YOU MIGHT HAVE AS YOU PLAN & PREPARE TO BRING A NEW PUP/S INTO YOUR FAMILY, HOME & LIFE? THOUGHTS? QUESTIONS? COMMENTS? ARE YOU & YOUR FAMILY PREPARED TO GIVE THE TIME INVOLVED TO PROPERLY RAISE & TRAIN A NEW PUPPY? DOES EVERYONE IN YOUR FAMILY WANT THIS NEW PUPPY? WHO WILL BE THE PRIMARY CARE GIVER FOR YOUR NEW PUPPY? ARE YOU & YOUR FAMILY READY, WILLING & ABLE TO COMMIT TO FOLLOWING THE FEEDING, WATERING, RAISING & TRAINING RECOMMENDATIONS THAT I, AS YOUR BREEDER, PROVIDE TO YOU AS A CHOSEN EMANUEL HOMESTEAD GOLDEN PUPPY OWNER? DO YOU OWN OR RENT YOUR RESIDENCE? WHAT TYPE OF RESIDENCE DO YOU LIVE IN? DO YOU HAVE A SECURELY FENCED YARD? DO YOU HAVE PLANS TO? DO YOU SECURE YOUR GATES? IF YOU DO NOT HAVE A FENCED AREA OF YOUR YARD ARE YOU PREPARED TO FULLY COMMIT TO THE CHALLENGES OF PROPERLY HOUSE TRAINING YOUR NEW PUPPY & FOLLOWING THE RECOMMENDATIONS/SUGGESTIONS PROVIDED BY ME AS YOUR BREEDER? WILL SOMEONE BE HOME DURING THE DAY TO LET THE PUPPY OUT TO GO TO THE BATHROOM? IF NO ONE WILL BE ABLE TO LET THE PUPPY OUT TO GO POTTY FROM YOUR FAMILY, WHAT ARRANGEMENTS WILL YOU MAKE FOR THE PUPPY?
PAGE 4 WHERE WILL YOUR NEW PUPPY BE HOUSED DURING THE TIME YOU ARE NOT AT HOME? DO YOU PLAN TO CRATE TRAIN YOUR NEW PUPPY? IF NOT, PLEASE EXPLAIN YOUR THOUGHTS WITH MY ALMOST 40 YEARS OF EXPERIENCE RAISING GOLDEN RETRIEVERS, I HAVE MANY SIMPLE & EFFECTIVE RECOMMENDATIONS, TECHNIQUES & TIPS FOR POTTY TRAINING & TRAINING YOUR NEW PUPPY. ARE YOU OPEN TO FOLLOWING MY RECOMMENDATIONS FOR POTTY TRAINING & OTHER TRAINING TECHNIQUES? DOES ANYONE IN YOUR FAMILY HAVE ALLERGIES TO DOGS? PERSONAL/FAMILY HOBBIES, INTERESTS, ACTIVITIES? DO YOU HAVE A REGULAR VETERINARIAN? IF SO, PLEASE LIST THE NAME, ADDRESS & PHONE NUMBER OF YOUR VET ARE YOU PLANNING TO SEEK SOME OUTSIDE TRAINING ASSITANCE? IF SO, DO YOU HAVE A SPECIFIC TRAINER IN MIND? YES NO - EXTRA THOUGHTS - DO YOU HAVE OTHER ANIMALS? WHAT KIND? DO YOU UNDERSTAND THAT SUBMITTING THIS QUESTIONAIR DOES NOT GUARANTEE THAT YOU WILL BE APPROVED FOR AN EMANUEL HOMESTEAD GOLDEN PUPPY? DO YOU UNDERSTAND THAT IF A PUPPY OF THE DESIRED SEX (GENDER) IS NOT AVAILABLE FROM THE NEXT EXPECED LITTER OR SELECTED LITTER, THE CLIENT SHALL EITHER ACCEPT A PUPPY OF THE OPPOSITE SEX OR ACCEPT A PUPPY OF THEIR CHOSEN SEX FROM THE NEXT AVAILABLE LITTER?
PAGE 5 DO YOU UNDERSTAND THAT THE PUPPY IS CHOSEN ON THE BASIS OF THE ORDER IN WHICH I RECEIVE DEPOSITS TO RESERVE A PUPPY? AS YOUR BREEDER, I CANNOT & DO NOT IN ANY MANNER GUARANTEE THE CLIENT A PUPPY FROM YOUR LITTER OF CHOICE. WHILE AS YOUR BREEDER, I AM CAREFUL NOT TO OVER-COMMIT THE PUPPIES FROM ANY GIVEN LITTER, I CANNOT MAKE GUARANTEES WHERE THERE ARE LESS THAN 6 PUPPIES IN THE LITTER. I DON T PLACE MY PUPS FOR BREEDING PURPOSES OR WITH FOLKS THAT ARE CURRENTLY BREEDING OR PLAN TO DO SO IN THE FUTURE. MY PUPPIES ARE, THEREFORE, SOLD WITH A LIMITED AKC REGISTRATION. THE PUPPY SOLD IS REGISTERED WITH AKC & CAN PARTICIPATE IN PROGRAMS & EVENTS, BUT NO LITTERS PRODUCED BY THIS PUPPY ARE ELIGIBLE FOR REGISTRATION. THIS AKC PROCEDURE HELPS PROTECT ESTABLISHED BREEDING PROGRAMS. DO YOU UNDERSTAND & AGREE WITH THE IMPORTANCE OF THE INFORMATION YOU ARE PROVIDING TO ME IN THIS APPLICATION AS A BREEDER WORKING WITH PROSPECTIVE NEW PUPPY OWNERS & THAT YOU HAVE ANSWERED THE QUESTIONS AS CLEARLY & HONESTLY AS YOU CAN? CHRIS J. DURNING/EMANUEL HOMESTEAD GOLDENS, LLC RESERVES THE RIGHT TO USE COMMENTS & INFORMATION INCLUDED IN THIS APPLICATIOIN FOR MARKETING PURPOSES. ALL INFO PROVIDED REMAINS CONFIDENTIAL & PRIVATE & NOT SOLD OR GIVEN AWAY TO ANYONE ELSE FOR ANY PURPOSE. DATE: SIGNATURE ONCE I HAVE RECEIVED YOUR COMPLETED APPLICATION, I WILL CONTACT YOU EITHER BY EMAIL OR BY PHONE TO DISCUSS YOUR ELIGIBILITY FOR AN EMANUEL HOMESTEAD GOLDEN RETRIEVER PUPPY!!!!! I LOOK FORWARD TO TALKING WITH YOU FURTHER & GETTING TO KNOW YOU BETTER!!!!!!!! SPECIFIC LITTER INFORMATION SIRE(FATHER) DAM (MOTHER) LITTER BORN
PAGE 6 NUMBER OF MALES IN LITTER FEMALES PUPPIES READY TO GO DATE DEPOSIT RECEIVED DEPOSIT AMT. CHECK # CASH BALANCE DUE [ALL INFORMATION COPYRIGHTED @-1978-2018 & IS THE PROPERTY OF EMANUEL HOMESTEAD GOLDENS, LLC & CHRIS J. DURNING - ALL RIGHTS RESERVED] Chris J. Durning, Breeder EMANUEL HOMESTEAD GOLDENS LLC "Goldens of Distinction" Celebrating Almost 40 Years of Excellence!!! 289 Barlow Cemetery Road Woodstock, CT 06281 CHECK OUT "Emanuel Homestead Golden Retrievers" ON FACEBOOK! http://www.facebook.com/emanuelhomesteadgoldens Email: emanuelhomesteadgoldens@yahoo.com Web Site: http://www.emanuelhomesteadgoldens.com Phone: 860-974-2893 Fax: 860-924-6660 Sign up for our free newsletter!