* Why are you interested in a Brittany?

* Have you owned a Brittany before?
Yes llllllll No

* Do you have any other pets?
Yes llllllll No

* If so, what other pets do you own?

* What is the gender and color of puppy are you interested in?

* What are you plans for this puppy? Competion showing, field trial, hunt tests, obedience/agility, hunting or family companion.

* Do you live in a house, an apartment or other? Rent or own?

* Do you have a fenced yard or a separate kennel run?
Yes llllllll No

* Where will the dog spend the day? Where will the dog spend the night?

* How many hours will your dog spend alone, in an average day?

* What is the make-up of your family? How many adults and how many children. What are the ages of the children?

* Is there any reason you would give up a dog? If yes, please explain.

* Do you agree that, if for some reason you are unable to care for this dog, I will be contacted about this first and given the chance to help?
Yes llllllll No

* Would you be willing to allow me to visit your home, by appointment?
Yes llllllll No

Please list a personal reference with contact information.

* Please tell me why you think your family would be the right home for a Brittany.

* Please give me your complete home address.