TO FILL OUT THIS APPLICATION PASTE INTO YOUR E-MAIL BROWSER AND SEND TO heathrob@atlantic.net OR PRINT THIS APPLICATION OUT AND SEND TO:
Teddy Bear Malinois
Heather Doucette
308 Oak Lane Track
Ocala, FL 34472
Name: ____________________________________________________
Address:___________________________________________________  
City,  ST,  Zip: _____________________________________________
Phone: (           )_________________ 
E-mail address_______________                                       


1.  Primary reason for wanting a Malinois:  




2.  Are you interested in a :      Male      Female       Either

3.  Have you owned a Belgian Malinois before:        Yes           No

4.  Have you bred a litter of puppies before:       Yes       No 
  
      If  Yes:  How many :    1-3  ;   4-7 ;   greater than 7 

      Date and Breed of most recent litter:   Date:    /    _ /____   Breed:   _____________________________

5.  Show experience: 
      None    
     Conformation   
     Obedience  
     Tracking                                     
     Field       
     Herding       
     Search and Rescue 
     French Ring     
     Schutzhund   
     Other:___________
 
6.  Housing/Yours:    Own  or   Rent
       Apartment  
      House    
      Condo
      Other:___________                                     

7.  Primary Housing/Dog: 
      Inside   
      Fenced Yard  
      Dog Run/Kennel
      If:     Fenced Yard--Fence height:______________
      If:     Kennel--Covered  or  Uncovered         
             Inside  Kennel    or       Outside Kennel----Height of outside kennel:____

8.  If dogs primary housing is Inside, where will it be kept during the day:
      Loose     
      Crate    
      Outside    
      Other:________________________

9.  If dogs primary housing is Outside will it be allowed in your house: 
    No    Yes-______Hours per week

10.  How will you socialize the dog: ________________________________        __________________________________________________________ 


11.  Please tell us about you and your family:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               




12.  Do you intend to show your puppy?  If so In what?


13.  Do you have children? If so how many and what ages?



14. How will you deal with the high energy level of your Malinois Puppy?


15. Do you intend to breed your puppy? If not are you going to spay/neuter the pup?



Signed: ________________________________   Date: ______________________