Please fill out your name and address:

Why are you interested in a Schipperke?

Have you had any personal experience with Schipperkes? And/or how have you learned about this breed?

Please tell us about canines who have shared your life in the past. What became of them?

What sort of temperment and personality do you desire in your pet?

What type of yard situation do you have?

Would your Schipperke live inside or outside? (mostly)

How would your Schipperke spend most of his or her time?

Do you have children?    YES      NO

If your answer is yes, please tell me their ages and interests:

Do you have other pets?   YES   NO

If your answer is yes, can you please tell me about them?   Breed, age and personality?

What are your expectations of and for your Schip?

What are your expectations of your breeder?

Have you ever trained a dog before?   YES  NO  

If your answer is yes, describe what kind of training this was:

Would you be willing and have the time to attend obedience classes?
YES NO

Please select any of the following that you have an interest in doing with you Schipperke:

Conformation/showing:    Obedience:    Agility:   
Flyball:    Therapy Work:    Just as a pet:

How do you feel about housetraining? Describe any past experiences.

What do you think about shedding?

What is your opinion of crate training?

Are you willing to follow our advice and suggestions regarding training, feeding, and care?   YES   NO

If possible please provide a veterinarian who can supply a reference.

Please list any and all concerns you have.