Please fill in the answers and then submit........
Churchill's
Miniature Pinschers, Harlequin Pinschers, & Chinese CrestedS
Puppy Questionnaire
25 QUESTIONS & 3 REFERENCES
Please answer the following questions as completely as you can, and return this form when you've finished. “THANK YOU”
Address ( please include your full address with road, city, state & zip):
1. Do you own or rent your home?
If renting is it okay with your landlord?
2. What breed are you looking for?
3. What reference materials have you read about the breed?
4. What is the main reason you have chosen this breed?
5. Have you ever owned this breed before? 
Or do you know of any one who has ever owned this breed before?
6. Are you interested in a male or female?
7. For Miniature Pinscher only:
Color preference? 

For Harlequin Pinscher only:
Color preference?






For Chinese Crested only: 
Preference ?

8. Are you willing to sign a spay/neuter contract? 
If no please explain?
9. Do you have other pet? 

If so are they spayed/neutered?
10. If you have pets what kind are they? 

How old?
11. Do you have children? 
If so what are their ages? (It is okay if you do have children I have 2, they are great with the pups as l long as they are taught on how to act around the pups)
12. Does everyone in your household agree upon getting a puppy?
13. Where will you be keeping your puppy at?
14. Have you ever house trained a puppy before?
15. Who will be the main care giver for the puppy?
16. Do you work? 


What do you plan on doing with the puppy while at work?
17. Do you have a fenced in yard? 
If yes, what type?
18. Will you be attending any puppy training classes?
19. If you are plaining on training the puppy your self have you ever trained a puppy before?
20. Are you will to give the dog back with all paper work if you are unable to keep him/her?
21. Have you ever returned a pet to a breeder? 
If so, why?
22. Have you ever given a pet away?

If yes, why?
23. Have you ever taken a pet to the pound? 

If yes, then why?
24. Do you understand the difference between a limited registration and a full registration?
25. Are you willing to keep in touch and let me know how the puppy is doing?
Three references are needed Please list below name & numbers
(please include your vet as one reference)
1.
2.
3.
Please let us know how you heard about us (hoobly, puppyfind, breedersnet,,,,,)
Thank you so much! This is for my piece of mind that I am placing the pup in a good home!!!