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All information is kept confidential.
We try to respond to each individual questionnaire submitted but do miss some occasionally.......so
please keep checking our web site and feel free to contact us periodically so that we know you are still interested.

 

E-mail:  sandra@sunmountainbordercollies.com

Web Address:  www.sunmountainbordercollies.com


Mark & Sandra D. Shults

PO Box 780,  Loon Lake, WA 99148-0780

Landline: (509) 233-8304 Fax (509) 233-8304 (call before faxing)

Cell phone: (Mark) 509-844-3544  (Sandra) 509-844-3214 

Please complete this questionnaire to assist us in placing the appropriate puppy in your home.  While I understand that it seems lengthy, please understand that it is vital for us to have as much information as possible so that we can match the needs of both your home and the individual puppy.  Feel free to elaborate on any questions using additional pages. The more information you can provide us about your home, needs, and wishes, the better we can match you with a puppy.

NO ANSWER IS RIGHT, JUST AS NO ANSWER IS WRONG.  All of the information gathered will be held strictly confidential and will not be sold or given to any outside source.

Prospective Owner Questionnaire;

 Name: ___________________________________________ Date: __________________________

Address: __________________________________________________________________________

__________________________________________________________________________________

Phone: (Home) __________________________ (Office) ___________________________________

E-mail address: ____________________________________________________________________

Please list names and occupation of all adults in the household: ____________________________

__________________________________________________________________________________

Please list names and ages of all children in the household: ________________________________

__________________________________________________________________________________

Do you have children/grandchildren who visit regularly?  

         NO ___     YES ___    # of  INFANTS _____    # of 1 5 yrs ______  

        # of 5 - 10 yrs _____    # 10 - 15 yrs _____

If you dont currently have children, do you plan to in the future?    YES___     NO ___  

Why do you want a Border Collie? ____________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________

Have you owned a Border Collie before?      YES___       NO___     

Please check any of the following activities you plan on participating in with your Border Collie?

         conformation shows___       agility___      tracking___    free style ___
         herding___       flyball___   search & rescue___       scent hurdling___   obedience____
         Schutzhund___     jogging___      hacking ___    camping ____     frisbee___   
        protection training___      puppy kindergarten___       basic obedience class___ 
        therapy work___   commercials/entertainment___    pet tricks____

       other________________________________________________________________

Please list the highest level of titles and wins you have achieved with your dogs (owner handled or professional handler).

Confirmation __________________________________________________________________ 
Agility _________________________________________________________________________
Obedience _____________________________________________________________________
Flyball ________________________________________________________________________
Tracking ______________________________________________________________________
Freestyle ______________________________________________________________________
Herding: AKC_____________ AHBA __________ASCA__________USBCHA ___________
Schutzhund/Ring Sport etc. _____________________________________________________
Other ________________________________________________________________________

Do you intend on obedience training your Border Collie?   NO ___   YES ___

    ON YOUR OWN___         WITH A CLUB ____ CLUB NAME _______________________ 

    PRIVATE TRAINER___   NAME ___________________________________________

Do you hope to breed Border Collies?   NO___

    YES___  YOUR GOAL IS _______________________________________________________
  _______________________________________________________________________________   

Have you ever done any breeding of dogs before?   NO___ 

    YES___   HOW MANY YEARS ____   # OF LITTERS ____ 

    WHAT BREED(s) ________________________________________________________ 

What other pets or animals do you own?    DOG___   # _________

    DOG BREEDS ____________________________________________           CAT___   # ________  

    OTHER_____________________________________________________________________

Do you or your neighbors have livestock?    YES___     NO___ 

Where will the dog be while you are home?     INSIDE___    OUTSIDE___      BOTH___

Where will the dog sleep as a puppy?    INDOORS:     LOOSE ___   CRATED ___ 

    SAFELY CONTAINED AWAY FROM THE FAMILY___ CONTAINED WHERE __________

   OUTSIDE:  LOOSE ___   KENNELED ___  OTHER _____________________________

Where will the dog sleep as an adult?    INDOORS:     LOOSE ___   CRATED ___

    IF CRATED WHERE WILL THE CRATE BE LOCATED _______________________________ 

    SAFELY CONTAINED AWAY FROM THE FAMILY___  WHERE _______________________

    OUTSIDE:  LOOSE ___   KENNELED ___  OTHER _____________________________________

How long will the dog be alone each day?      LESS THAN 2 HRs___       2-4 HRs___       4-8 HRs___  

    MORE THAN 8 HRs___

Who in your family will be primarily responsible for;

daily care _____________________________    weekly grooming __________________________


clean up ______________________________     training _________________________________

What arrangements will you make for the dog's care when you are away from home for an extended period of time?
   
    BOARDING KENNEL ___    WITH A FRIEND ___  

    DROP IN FRIEND OR DROP IN DOG SITTING SERVICE ___   

    UNATTENDED WITH ADEQUATE SHELTER, FOOD AND WATER___    

    OTHER____________________________________________________________

 

When the dog travels with you in your vehicle where will it ride? 

     IN THE BACK SEAT __    IN THE TRUCK BED___    IN A DOG TRAILER

     LOOSE___      IN A CRATE___    SECURED WITH A HARNESS___

    OTHER ______________________________________________

Do you have a fenced area for the dog?    NO___     YES___    

    aprox. size    _______  x _______

    type of fencing    BLOCK___     WOOD___     CHAIN LINK___  OTHER_____________________

    fence height    3'___     4'___     5'___     6'___   

    type of shelter    DOG HOUSE___     SHADE TREES___     PATIO___     OTHER______________

    type of area    YARD___     DOG RUN___     OTHER______________________________________

    surface    GRASS___     CONCRETE___     DIRT___     OTHER_____________________________

Have you ever used a crate in housetraining a dog?    NO___YES___    

Veterinarian information:

               Name: ____________________________________________________________

Clinic Name: ________________________________________________________

Address: ____________________________________________________________

Phone: ______________________________ 

Do you currently belong to any dog clubs?   NO___YES___    
Please list  _______________________________________________________________________
_________________________________________________________________________________
Please list past dog club memberships: _______________________________________________
_________________________________________________________________________________
Do you currently subscribe to, any dog magazines or publications?    NO___YES___    
Please list  ________________________________________________________________________
__________________________________________________________________________________
Please list past publications: _________________________________________________________
__________________________________________________________________________________     

Please check all that apply to the type of dog you are looking for:

  MALE___     FEMALE___     NO PREFERENCE___

  ROUGH COAT___     SMOOTH COAT___     NO PREFERENCE___

  PRICK EARS___     TIPPED EARS___     NO PREFERENCE___

  BLACK/WHITE___    RED/WHITE___    OTHER_________________    NO PREFERENCE ___

  LOW DRIVE___     MEDIUM DRIVE___     HIGH DRIVE___

Please describe any other particular physical or character attributes that are important to have in your puppy?

 

  

How did you find us?     ADVERTISEMENT___     REFERRED BY WHO ____________________    

     INTERNET___     OTHER___________________________________________________________

Please provide the names, addresses, and phone numbers of at least three references that I may contact. These may include dog trainers, Border Collie owners, other dog owners, your veterinarian, friends, or neighbors. Anyone who knows you well enough to recommend you as a dog owner (family members excluded, please).

1. 

 

2. 

 

3. 

 

I certify that the information I have provided is true and complete to the best of my knowledge and that all household members have taken part in filling out this questionnaire.

________________________________________________________________________________

Signature _________________________________________ Date: __________________________

Thank you for taking the time to answer these questions. While I understand that it seems lengthy it is vital we have as much information as possible so that we can meet your needs as well as the puppies.  ALL INFORMATION IS HELD IN THE STRICTEST OF CONFIDENCE AND WILL NEVER BE SOLD OR RELEASED.

 

 
 
Home Our BC Family Herding Gallery New Litters Past Litters ContactUs
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Copyright 1999 by [Sun Mountain Border Collies]. All rights reserved.
Revised: 10 Jan 2012 16:54:15 -0500
Sandra D. Shults
1-509-233-8304
Loon Lake, WA