Name      
Street    
City      
State     
Zip Code  
Telephone 
E-Mail    
Occupation

1. What made you decide to get a dog, especially a Wheaten?
   
   
   
   
2. How soon do you want a puppy - (latest acceptable date) ?
   
   
   
   
3. Do you have other particular breeds in mind besides a Wheaten?
   
   yes no
   
   If yes, which breed(s) ?
   
   
   
   
4. Please characterize what you want in a "dog".
   
   
   
   
5. If not self-evident in question 4, why do you want these traits, or characteristics in the dog?
   
   
   
   
6. Do you have a dog now, or have you had dogs before?
   
   yes no
   
   If yes, how were the dogs handled in your home then?
   
   outside dog farm dog house pet hunting dog
   
   
7. What happened to the dog?
   
   Still lives here - age
   
   Died - how
   
   Other - specify
   
   
8. Are you interested in an older dog? yes no
   
   
9. Do you want a male female either
   
   
10. Do you consider the dog to be:
    
    House pet Outside dog for security Farm help Other
    
    
11. Where will your dog spend most of it's time?
    
    a) During the day b) At night
    
    
12. Is your yard fenced? yes no
    
    If no, do you have a fenced dog run? yes no
    
    If no, do you plan to put in either of these in the near future? yes no
    
13. How many persons are in your family; and what are the ages of your children and/or grandchildren living in your home or spending a lot of time with you?
    
    
    
    
14. Does every family member at your home want a dog? yes no
    
    If no, please explain
    
    
    
    
15. How do you expect your dog to behave? (e.g. will you allow it on the furniture; should it be protective, etc, etc.)
    
    
    
    How will you accomplish this?
    
    
    
    
16. As a disciplinarian, would you consider yourself to be:
    
    stern indecisive impatient slow to make decisions middle of the road soft touch patient can lose interest easily other
    
    
17. How much time are you realistically able to spend with your youngster?
    
    Go for walks and/or play everyday
    Some, but I travel quite a bit
    Go to obedience training and work with the dog as a puppy and adult whenever necessary
    Buying for the kids to have as a companion
    Buying for my current dog to have a companion
    
    
18. Which family member will care for this "dog" - and is this mutually agreeable by all concerned?
    
    
    
    
19. Who will train the dog?
    
    
    
    How will the dog be trained? (e.g. obedience school, home, etc.)
    
    
    
    
20. Has someone accepted responsibility for cleaning up the yard; and is this a firm comittment on their part?
    
    yes no
    
    
21. Are you willing to spay or neuter your dog if placed with you and I make such a request?
    
    yes no
    
    Such a request is usually made with regard to whether the dog should be bred or not -- shown or not.
    
    If you do not agree with altering a dog, please explain.
    
    
    
    
22. Do you understand the financial commitment involved, (beyond the original cost), in having a pet, especially a Wheaten?
    
    yes no
    
    
23. Who is going to groom (cut, bathe, comb) the dog?
    
    You, the owner
    Professional groomer
    Haven't decided yet
    
    Do you understand that the Wheaten needs several careful combings and brushings per week; nails cut every 7 - 10 days?
    
    yes no
    
    
24. Where did you get my name as a breeder?