Puppy Interest Questionnaire

Puppy Interest Questionnaire
Name *

First Name Last Name
Email *
example@example.com
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *

Area Code Phone Number
Previous Dog Experience (select all that apply) *

Currently have a dog Currently have a PWD Previously had a dog Previously had a PWD No dog experience
Why do you wish to purchase a Windward Portuguese Water Dog? *

Companion or Family Pet Interested in a Show Prospect (conformation) Interested in a Working or Performance Dog (obedience, rally, agility, therapy work) Want to breed Portuguese Water Dogs Junior Showmanship
Describe why you are interested in a Portuguese Water Dog. *
Tell us about your home. Select all that apply. *

Own Rent (landlord written approval is REQUIRED prior to purchase) Invisible Fence Wood or chain-linked fenced backyard No fence currently
Describe your home in detail and how you plan to provide your PWD with adequate exercise. *
Select all that describe your employment situation. *

Full-time Part-time Work from home Travel required Retired
Describe your employment situation in more detail, including how long your dog will be alone during the day and your plan for that time. *
Who is currently living in your home? Select all that apply. *

Spouse / Partner / Significant Other Children Dog(s) Cat(s) Live alone
List names and ages of all people and pets (include the breed) in household. *
Are your current pets up to date on vaccinations? *

Yes No I currently do not have any pets.
Are ALL of your current pets spayed or neutered? *

Yes, ALL of my pets are spayed/neutered. No I currently do not have any pets.
Select your preference for a Windward PWD puppy. Please note this is a wish list ONLY. At no point will a potential puppy family be allowed to pick their puppy. Puppies are placed in homes based on Robin & Christie's evaluation of each puppy as well as the needs of each potential family. *

Curly Wavy No preference of coat type Male Female No preference of sex Black with little to no white markings Black with substantial white markings Brown No preference of color
Provide any additional information that you would like to share with Robin and Christie as they consider you for a Windward Portuguese Water Dog puppy.
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