Contact Information

Name

Address

City

State

Zip

E-mail

Daytime Phone 

Evening Phone

Fax 

Please include your area code.

Your Home Environment

Which of the following best describes your current residence? (Check one)
Own Home  Rent/Lease Home  Rent/Lease Apt  Other

Neighborhood Urban Suburban Rural

Do you have a fence?  No  Yes  Type of Fencing
Fence Height    Type of Gates
Is fence solid & secure?  No  Yes Invisible Fencing

If you have children at home, please list ages and gender. 
 

Other children who will visit on a regular basis?  

Who will care for the dog on a daily basis?  

Does this person approve of getting the dog?  Yes  No
Please list other persons (and ages) in the household who will have contact with the dog.
 

Other pets presently in the household [Breed, Type, Age, Sex of each] 
 

Are the above animals spayed/neutered?  Yes  No

Who will be your veterinarian?  Name  
Vet Phone Number  

What dogs have you previously owned?  (Please provide a brief explanation about how long you owned them and what happened to them.)
 

For what reason(s) would you give up a dog?

Has your dog ever caused you to be in a court situation? No  Yes (Please explain why.)

Are you familiar with the temperment & characteristics in general of welsh terriers?  Yes  No

Preference for Welsh Terrier Sex?
Preference for Welsh Terrier Age?
Any other requirements?

How often and for how long will the dog be at home alone? (i.e. with no human family member)

Does everyone in the household work? Full Time  Part Time  hours per week

Where will the dog be kept during the above hours?

Where will the dog be kept during the night? [as a puppy]

Where will the dog be kept during the night? [as an adult]

 MUST BE ANSWERED  Do you have a pool?  No  Yes 
If yes, what barriers will be/or are installed to prevent the puppy from falling into the pool?

On vacations, what would you do with the dog?

How will the dog get exercise besides a fenced enclosure?

Do you know anyone who is a member of the Welsh Terrier Club of America Inc or anyone who owns a welsh terrier?Yes  No
Why do you want a welsh terrier?

How would you describe the trainability and temperment of a welsh terrier?  (Please use your own words, rather than what you read in a book or on the internet.)

What method would you use for training?

Any additional comments you'd like us to consider?

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$1800   $300 deposit required
~ Check made payable to Carole Beattie ~