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. Please be as detailed as possible. 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

General Information

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?

Tollers and Puppies

Have you met a Toller?
Yes  No

If so who's Tollers have you met?

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

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 3 questions? Please Explain.

Potential Breeding Puppy People Only: How important is it that your pup
be clear/normal vs carrier for the 4 Optigen/OFA Genetic Tests for
PRA/CEA/JADD/CP1? Please explain.

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

Plans for you Cinnstar Pup. Please number and list in preference to all that apply:
Conformation Shows,   Field Trials,   Hunt Tests,   Working Certificate Tests,  
Agility,   Tracking,   Obedience,   Hunting,   Any Other Performance Events

Have you ever competed or participated in the dog-related activities mentioned above?
Please detail.

Canine Experience

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

Please list all dogs owned in the last 15 years, including Breed(s), 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.

Housing and Living Conditions

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 an outdoor kennel? Yes  No
Do you plan to crate train your Toller or keep it in a crate? Yes  No

Please explain how you plan to confine your Toller in the last 5 Questions?
Please be detailed and include details for nightime and when you are not at home.

When you go on vacation, what plans do you have for your Toller?

References and Additional Information

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

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

Food & Feeding

Agreement/Guarantee