GalLexi German Shorthaired Pointers

CONTACT INFORMATION:
NAME
	(Complete as name to be shown on Registration including co-owner, if any)
ADDRESS
CITY			STATE		ZIP
HOME PH	WORK PH
EMAIL	CELL PH
HOW LONG HAVE YOU LIVED AT THIS ADDRESS?
REFERRED BY:

BREED INFORMATION:
HOW DID YOU HEAR ABOUT THIS BREED?
WHAT REFERENCE MATERIALS HAVE YOU READ?

WHAT DO YOU EXPECT THE ACTIVITY LEVEL OF THIS BREED TO BE?
VERY HIGH HIGH MODERATE BELOW AVERAGE

TYPE OF DWELLING:
HOUSE CONDO APARTMENT MOBILE HOME

WHAT KIND OF FLOOR SURFACES WILL THE DOG BE ON IN THE HOUSE?

IF RENTING, PLEASE GIVE CONTACT INFORMATION OF LANDLORD:
NAME:
ADDRESS:
PHONE:

FAMILY STATUS:
SINGLE MARRIED - SPOUSE NAME:

DOES ANYONE IN YOUR HOUSEHOLD HAVE ALLERGIES TO ANIMALS? YES NO
IF YES, TO WHAT AND HOW SEVERE?

CHILDREN LIVING AT HOME:
NO YES - NAMES AND AGES:

PUPPY GENDER PREFERENCE:
MALE FEMALE WHY :


*WHAT ARE YOUR PLANS FOR YOUR GalLexi* GSP?**
SHOW DOG OBEDIENCE AGILITY HOUSE PET THERAPY DOG HUNTING

HAVE YOU EVER SHOWN A DOG TO IT'S CHAMPIONSHIP? YES NO

HAVE YOU EVER SHOWN A DOG TO ANY PERFORMANCE TITLES? YES NO

DO YOU INTEND TO BREED THE DOG? YES NO

PREVIOUS DOG EXPERIENCE:
HAVE YOU EVER OWNED A DOG BEFORE?				YES NO

HAVE YOU OWNED A GSP BEFORE?				YES NO STILL DO

LIST DOGS CURRENTLY OWNED INCLUDING BREED, REGISTERED NAME, AND TITLES:


LIST DOGS PREVIOUSLY OWNED INCLUDING BREED, REGISTERED NAME, AND TITLES:


HOW LONG DID YOU LAST PET LIVE? WHAT WHERE THE CIRCUMSTANCES OF ITS' DEATH?


DO YOU HAVE ANY OTHER ANIMALS? NO YES - PLEASE LIST:

REASON FOR WANTING A GalLexi GSP:


ARE YOU CURRENTLY A MEMBER OF A DOG SHOW CLUB, OBEDIENCE CLUB, OR OTHER DOG CLUB? LIST CLUBS IN WHICH YOU ARE A MEMBER.


WILL YOU BE ATTENDING ANY TRAINING CLASSES? YES NO
IF YES, AT WHAT AGE WILL YOU START?
WHICH ACTIVITIES/COMPETITIONS ARE YOU INTERESTED IN AND WHO IS THE TRAINER?


HOW FAR WILL YOU TRAVEL TO GET YOUR PUPPY?

WHAT AGE DO YOU WISH TO GET YOUR PUPPY?

HAVE YOU CONSIDERED AN OLDER DOG INSTEAD OF A PUPPY? YES NO

IS SOMEONE HOME DURING THE DAY? YES NO

WHO WILL BE THE PRIMARY CARE GIVER?

HOW LONG WILL PUPPY BE LEFT ALONE?

HOW MANY HOURS A DAY WILL THE PUPPY BE KEPT OUTSIDE?

WHERE WILL PUPPY BE KEPT AT NIGHT?

WHERE WILL PUPPY BE DURING THE DAY?

DO YOU HAVE A FENCED YARD?		YES NO		APPROXIMATE SIZE:

HAVE YOU EVER HOUSE TRAINED A DOG BEFORE? YES NO

HAVE YOU EVER RETURNED A PET TO THE BREEDER? IF SO, WHAT WERE THE CIRCUMSTANCES?


HAVE YOU EVER GIVEN A PET AWAY? IF SO, WHAT WERE THE CIRCUMSTANCES?


HAVE YOU TAKEN A PET TO A POUND OR SHELTER? IF SO, WHAT WERE THE CIRCUMSTANCES?


CURRENT OR PRIOR VETERINARIAN FOR REFERENCE:
NAME:
ADDRESS:
PHONE:

DO YOU UNDERSTAND THE DIFFERENCE BETWEEN LIMITED AND FULL REGISTRATION?
NO YES
(WHEN YOU CLICK [SUBMIT] THIS FORM WILL BE EMAILED TO *GalLexi*)