Maverick Ranch - Whippets - Jewelry

Date

Name

Address

City/St/Zip

eMail

Day Phone

Eve Phone

Marital Status

Married Single Divorced Widowed

Spouse or Significant Other's Name:

Dwelling

House Apartment Townhouse Duplex Other

Do you have a fenced in yard?

Yes No

Yard Size

Fence Height

Do You

Own Rent

If you rent, please list your landlord's name(s), address, and phone.

Does you rental agreement allow pets

Yes No

Name and Address of nearest relative not living with you.

Are all members of your household in agreement with bringing a Whippet into your family? (Please comment)

Please list all animals living with you (including small caged animals as well as livestock):

If you have a dog in your residence now, have you ever introduced it to a new dog at your residence?

Yes No

How did your dog react (Please Explain)?

Have you ever owned a Whippet or other Gazehound before

Yes No

If yes, what breed?

Still have Died Other

Lease explain if you checked "other" or explain how the dog died:

Who is you regular veterinarian?

Clinic

Doctor

Address

Phone

Check as many of the following that apply:

What do you want your whippet to be?

House Pet
Breeder
Racer
Obedience
Watchdog
Lure Courser
Show Dog
Field Courser

What will your Whippet need to get along with?

Other Dogs
Cats
Birds
Small Rodents
Livestock
Children
Men
Women
Other

Do you have a preference for:

Male Female Color

Where will your Whippet be most of the time?

In the house Outside in the Yard Outside in Kennel

How many hours of the day will the dog be alone?

How will you contain your Whippet during your absences from home?

Crate Kennel Loose in House
Loose in House with dog door access
Outside in Yard

Where will your Whippet sleep?

How do you plan to exercise your Whippet?

What specifically attracted you to a Whippet?

Do you object to a personal inspection of your premises interview?

Yes No

Please list convenient times for both

Please list name and phone numbers of three personal references:

Personal Reference 1:

Personal Reference 2:

Personal Reference 3:

Thank you for your interest in one of our puppies.