Name:
E-mail address:
Address1:
Address2:
City:
State:
Zip:
Phone:
Fax:

 

1. Are you married? Yes No

 

2. Do you have children, If so what are their names and ages?

 

3. What type of work do you do and who would be the primary
care giver, for your Cavalier King Charles Spaniel?

 

4. What type of hobbies do you currently participate in?

 

5. Do you have a fenced in yard? Yes No
Please tell me your plans for housing and exercising
your Cavalier King Charles Spaniel.

 

6. Have you ever owned
a Cavalier King Charles Spaniel?		 Yes No

 

7. Do you currently own any other dogs, pets, etc?
If yes, please list them below along with breed
age, sex and spay/neuter status.

 

8. If you currently do not own any dogs, can you tell me
about your past exposure to dogs and dog ownership.

 

9. Have you ever had to return or remove a dog from your care,
because of problems with temperament or personal changes
in your lives?
If yes, please explain.

 

10. What made you decide to purchase
a Cavalier King Charles Spaniel?

 

11. Do you plan on participating in any of the following activities
with your Cavalier King Charles Spaniel.
(Please check all that apply).
Agility
Breeding
Conformation
Family Pet
Obedience
Tracking
Therapy
Other (Please explain in the box below)

 

12. Are you are aware of the health problems
that are possible within the Breed?		 Yes No

 

13. Have you read any books or articles
about the breed?		 Yes No

 

14. Do you prefer a male  or female
Please state why?

 

15. Do you have a color preference? Please tick if so.
Blenheim (red & white)
Tri-color (black, white with tan markings)
Ruby (Red)
Black & tan (black with tan markings)

 

16. How did you hear about Runabout Cavaliers?

 

17. Are you a member of a Dog Breed Club? Yes No

 

18. Would you be interested in joining the
Cavalier King Charles Spaniel Breed Clubs?		 Yes No

For more information concerning these two clubs,
you may visit their websites below, or mail for
Club applications.
CKCSC URL http://www.ckcsc.org

ACKCSC URL http://www.ackcsc.org
 

 

Please list at least two references (including a veterinarian,
person active in dogs, or close acquaintance preferred).
Please include a phone or fax number for each reference
and an email address if possible.

 

 

 

 

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