Name:_________________________________________________ Address:________________________________________________ City,State,Zip:___________________________________________ Home phone:________________________ Work phone:________________________ Email Address:_______________________________ Referred By:________________________________ How did you hear about us?__________________________________________________________ What are you looking for in a dog?_____________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ When do you want to get a puppy?____________________________________________________ Single/Married/Married W/kids?______________________________________________________ Age of Children?_________________________________________ Rent/Own:_____________________ May I contact your Landlord?_______________________________ Do you have a yard?___________Is it fenced?____________ How long have you lived here?_________ Have you considered the costs involved in caring for your dog?_________________________ Do you have time and commmitment to housebreak and train a puppy?________________ Will you or someone be able to interact with your dog throughout the day?_____________ Staffordshires like to play hard and need daily exercise. They want to be involved in your family. How will you exercise your dog?___________________________________________ What are your plans for socializing and training your puppy and for how long?_________________ __________________________________________________________________________________ Who will be the primary caregiver?________________________ Where will the puppy be kept during the day?__________________________________________ Where will the puppy be kept in the evening?____________________________________________ How many hours a day will the puppy be left alone?________________ Have you ever owned a dog before?_______What kind?________________________How long?_______ If you do not still have the dog,why?________________________________________________ _______________________________________________________________________________ Ever given a pet away?Why?______________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Does anyone in your household have allergies?______________________________________ What are you looking for in a Staffordshire Bull Terrier?_________________________________ ______________________________________________________________________________ Have you ever owned a Staffordshire Bull Terrier before?_______________________________ Do any of your family or friends own a SBT?_______________________________ Please list references that can vouch for your good pet ownership and responsibility ex: veterinarian,friends,neighbors,training centers etc..... 1._____________________________________________ 2._____________________________________________ 3._____________________________________________ Do you have a sex preference?___________________________________ Do you hope to breed eventually?____________________________ Do you have any color preference?___________________________ Flashy(extra white markings) or plain?____________________________ Have you talked with/viewed any other SBT breeders?_________________ If yes, please list site or breeder___________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Are you on a waiting list for any other SBT pup?____________________________ Are you interested in showing your SBT in Conformation?________________________________ Have you ever finished a dog to its Championship?_______________________________________ Are you interested in competing in agility, rally, lure coursing or obedience?__________________ Have you ever titled any dogs?____________________________________________________ Do you understand the difference between a limited registration and a full registration?________ ________________________________________________________________________________ If purchasing a pet quality pup,are you opposed to s/he being spayed/neutered prior to you receiving it?________________________________________________________ If considered for placement, are you willing to put down a deposit?___________________ I know there is alot of questions but these puppies are my responsibility and we want the best families for them. The families that are considered for placement of the puppies will be people that we will keep in contact with every once in a while to check on the pups and see how they are doing. Thank-you so much for your patience in filling this out it really means alot to the new family member! :) Thank-you Jason & Nikki Deville NorthernKnight Staffords Home of CH. Claymore's Beachmaster(Chief) & OldeTymes Bell of the Ball