First Name Last Name Phone

Address City State Zip

E-mail

How did you first learn about Recherche Goldens? Why would you like to own a pup from us?

What gender of a puppy are you looking for?: No Preference Only Male Only Female Prefer Male Prefer Female

Would you plan to breed this dog? Yes No Maybe Would you spay or neuter your dog? Yes No Maybe

Do you have any pets now? Yes No If so what kind?

Have you ever raised a puppy? Yes No

How many people live in your household? Are their any children? Yes No If so what are their ages?

Is someone in your household home during the day? All the Time Most of the Time Some of the Time Not Much Never If not, where will your dog be kept while you are out?

Do you live in a: House Apartment Condo/Townhouse Other Where will your dog spend most of his time when he is at home?

Do you have a fenced yard or other enclosure for a dog, if so please describe?

Will you agree to provide the dog with proper housing, food and veterinary care for its lifetime? Yes No Other (explain next question)

Have you ever owned an English Golden Retriever before? Yes No

Have you read through our entire FAQ page on our website (including Pricing, Extend Training Program, etc...)? No Yes

Which litter where you most interested in getting a puppy from? No Preference Amalie Anna Gwen Sadie Vicky Kati

Would you be interested in our extended training program called Puppy Academy? Definitely No Definitely Yes Possibly Probably No

Tell us when you were desirous of getting a puppy:

Is there anything you would like us to know that hasn’t been covered in this questionnaire? Do you have any questions you’d like to ask us about Recherche Goldens or about Golden Retrievers in general?

Once you click Submit you will be redirected to our Home Page. Your information has been received.