Harmonic Collies Potential Puppy Owner Questionnaire
~Please complete this Questionnaire then click Submit Button after Completion~ This Application Is Just A Beginning Step In The Process. All information will be Confidential to be used only by Harmonic Collies for consideration of a Harmonic Puppy. ~Please Complete This Entire Form Below~ Thanks for your cooperation and interest in Harmonic Collies~
Full Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Phone Number
-
Area Code
Phone Number
E-mail
How did you learn about Harmonic Collies?
Please Select
Veterinarian
Another Breeder
Internet
Friend
Do you currently own other pets?
If so, please describe Species; breed if a Dog, and Age.
If you do not currently have a Dog have you currently own a Dog If so what Breed?
What happened to that/those Dogs(s). If they are deceased how/why They died and at what age?
Why have you chosen a Rough Collie to become part of your family?
Are you familiar with the Rough Collies Grooming Needs, Nutritional, And Level of Activity?
Do you have any anticipated Major Life Event Changes, Caring for Elderly Sick Relative, Pregnancy, Etc? IF “Yes” please describe
Do any Family Members have Allergies to Dogs?
Are any family members afraid of dogs?
Is it a problem if your collie should bark excessively?
Is someone home during the day, or able to get home to place puppy Outside for “POTTY”? If “No” what arrangements will you be making for you new pup?
Do you live in a (House/Apartment/Condo?)
Do you (own/rent/lease) your Residence?
Where will your Collie be housed at Night?
Please Select
In house in Crate
Basement
Yard with Dog House
Dog House with Run
Basement with Crate
Other
Do you have a Fenced Lot with Gate?
Please Describe your Yard Size And Fencing?
If your Yard is not fenced or you do not have a Chain-Link Fence Would you be willing to install it before you bring your Puppy Home?
Collies live approximately 10 to 14 year. Are you committed for all these Collies Needs throughout His/Her Life?
What Gender do you prefer?
Are you looking for a puppy or Adult ?
Would you consider a Champion Adult?
If you have selected a preference, would you be willing to want the Opposite Sex if Your Preference is not available?
Do you have a Color Preference for your Collie pup? If Yes, Please Explain.
Would you consider a different Color Preference that is available?
Have you ever gone to a Dog Show? If Yes, What Interested You There?
Is this Puppy/Adult for a Show breeding Home?
Is this Puppy/Adult for a Companion Pet Home?
Is this Puppy/Adult for agility?
Do you have any interest to Train This Puppy for future use in Obedience, Agility, Herding, Conformation Shows?
Who will be the Primary Caretaker for Feeding, Training, Exercise, Grooming, and Socializing for this Collie Puppy?
Have you Crate Trained a Dog/Puppy?
Do you Agree to Sign a CKC NON-Breeding Contract ?
Can you give your Puppy Unconditional Love?
Are you willing and able to meet with us in our home for a personal interview?
Who are you buying this Puppy for?
Is this puppy going to be a surprise for someone special in the family?
How do you plan on exercising your Rough Collie?
Do you have a Regular Lawn Service?
How much exercise do you think a Rough Collie requires per day?
Would you be willing to provide us with References, who know how you are with animals
Are there any children in the family? If so, please state their gender and ages.
Are you willing to take this dog to obedience classes so that he/she will be an enjoyable Companion and a Good Canine Citizen?
Please include any comments that will help me select the right puppy for you?
Are there Restrictions in your neighborhood regarding dogs?
By Submitting This Application To Harmonic Collies. I Am Acknowledging that the Information Entered on this Application is Completely Correct and True. I understand that is Application is the Beginning Step in the Interview Process. I understand that sending this Application Does Not Automatically Entitle Me to a Puppy/Dog? I understand that All Information will be Confidential to be used only by Harmonic Collies for Consideration of a Harmonic Puppy/Dog. Thank You For Your Interest In ~ Our Collies.~
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