Atlantic Sable Shilohs Puppy Application
 
Please answer the following questions and return to:
Atlantic Sable Shilohs c/o Jayne Polem, 1469 Church Street, Port Williams, Nova Scotia, Canada, B0P 1T0
Or save and email: Jayne@AtlanticSableShilohs.com
Or print and Fax: 902-542-0578
Questions? Call: 902-542-7284
 
Although these questions may seem personal, they are important in assisting us to meet your expectations.
Circle all that apply and please print clearly. Thank you!
 
Name: ___________________________________________________________  
Address:__________________________________________________________  
City: _____________________________________________________________  
State / Province: ____________________________________________________  
Zip / Postal Code: __________________
 
Home Phone: ______________________ Work: ______________________ Cell: ____________________  
Email: ________________________________________________________
 
1) I would like                 a) Male                   b) Female  
2) I would like                 a) Plush coat         b) Smooth coat                c) Not sure  
3) I would like                 a) Sable                  b) Dual                              c) Not sure
 
4) The temperament I expect from my dog would be:
                            The mailman knocks at the door with a package delivery, I want my dog to:
a)       Bark, then make friends
b)       Bark and not make friends
c)       Bark, then chew him up
d)       Other: __________________________________________
 
My dog and I are taking a walk in the park and I see some old friends, I want my dog to:
a)       Wag his/her tail
b)       Ignore them
c)       Attack them
d)       Other: ___________________________________________
 
5) My dog will spend most of his/her time:
a)       In the house
b)       In the fenced yard
c)       In a kennel run
d)       On a chain
e)       Running loose
f)        Other: ____________________________________________
 
6) I am interested in training my dog in:
a)       Obedience
b)       Agility
c)       Search & Rescue / herding
d)       Therapy / seeing eye
e)       Schutzhund
f)        Other: ___________________________________________
 
7) I am interested in show and/or breeding:                Yes                No
8) I am interested in a pet and plan to spay / neuter:                Yes                No
9) I have owned ________ dogs in the past ______ years.
10) My dogs were:
a)       Given away
b)       Killed in accidents
c)       Euthanized because _______________________________________________________
d)       Died of old age
e)       Other: _____________________________________________
 
11) My household consists of _____________ dogs (age, breed, sex)
 
12) My household consists of:Adults
a)       Adults (#) ______________
b)       Cats (#) ________________
c)       Children (# & Ages) ________________________________________
d)       Birds (type) _______________________________________________
e)       Other: ______________________________________________________________________________________________________________________________________________________
 
13) Do you expect to have children?                Yes                No
 
14) The adults in my household are: 0-20 20-30                30-40                40-50                50-60                65 & up
 
15) Comments: 
   

 
Note:    If you would like to be added to our list for a puppy, or a specific upcoming litter, please enclose a $600.00 deposit. 
            Should we be unable to fulfill your request, your deposit will be returned in full.
 
Thank you for your cooperation. Should you have any questions, please contact me at:
 
Atlantic Sable Shilohs
1469 Church Street
Port Williams, Nova Scotia
Canada, B0P 1T0
Phone: 902-542-7284
Fax: 902-542-0578