Dear Potential Puppy Owner,

We know this Questionnaire is detailed, and some questions asked may seem invasive. Please do not be offended. We like to know about the families our pups go to, and this questionnaire answers most of our questions about you. NOTE: Some internet security programs or settings will not allow the questioner to be sent. Or it appears to be submitted but ends up in cyberspace. If you have not received a reply from us in a few days, please email us directly or call and we will send you a Word Doc for you to fill out.

Thank You Very Much,

Laura and Don White

Date:

Name:

Name of Spouse if applicable:

Names of Children if applicable:

Ages of Children if applicable:

Address:

Work Phone:

Home Phone:

Email Address:

Profession:

Home Office?

Have you met a Toller? If so who's?
Yes  No

How did you hear about Cinnstar Retrievers?

Have you familiarized yourself with the breeds characteristics? How?

Do you have a regular Veterinarian? If so, please list their name and phone number.

Litter of Interest:

Future Litter (approximate date you are interested in getting a pup):

Preference of Puppies Sex:

Male   Female   No Preference

Optigen Testing for PRA Marker:

I want the blood test done.
I do not want the blood test done.

How important is it that your pup be a pattern A?

Very Important, will not take a pup other then a Pattern A
Important, but I want a pup even in Pattern B.
Does not matter

Preference of Puppies Color

Light   Medium   Dark   No Preference

Preference of Puppies White Markings

Lots of White   Medium   Not Much   No Preference

How strong do you feel about the last 5 questions? Please

Explain

Are you on any other breeder's waiting list? If so, how many lists are you on?

Canine Experience:

Please list all dogs currently owned including Breed, Titles, and anything else you wish to mention.

Please list all dogs owned in the last 15 years, including Breed, Titles, and why they are no longer with you (if applicable)

Are you currently a member of
The Nova Scotia Duck Tolling Retriever Club (USA) Yes  No
The Nova Scotia Duck Tolling Retriever Club of Canada Yes  No

Please list any other Dog Clubs you belong to.

Will/Do your dogs live in the house Yes   No
Will/Do your dogs live outside? Yes  No

Do you have a fenced yard? If yes what is the height of the fence?

Do you have a kennel? Please list percentage of time your Toller will spend
in each and explain how you will confine your dogs.

Plans for you Cinnstar Pup, please number in preference to all that apply:
Conformation Shows,   Field Trials,   Hunt Tests,   Working Certificate Tests,  
Agility,   Tracking,   Obedience,   Hunting,   Other  

Please list two (2) references that can confirm your good character and dog experience.
Please include phone numbers.

Please let us know anything else you would like us to know about you.

Food & Feeding

Training at Cinnstar

Agreement/Guarantee

Cinnstar Retrievers Laura and Don White 956.347.3806 Cinnstar Retrievers

This site designed and maintained by Laura White