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Name:
Email:
Address:
City:
State:
Zip:
Phone:
Fax:
URL:
Marital Status:
Do you have children? If so, what are their ages?
What type of work do you do? Who would be the primary care giver for your Cavalier King Charles Spaniel?
In what type hobbies do you currently participate?
Do you have a fenced in yard?
Yes
No
Planning to have one installed
Please tell us your plans for housing and exercising your Cavalier King Charles Spaniel.
Have you ever owned a Cavalier King Charles Spaniel? If yes, state details.
Do you currently own any other dogs, pets, etc? If yes, please list them below along with breed age, sex and spay/neuter status.
If you currently do not own any dogs, can you tell me about your past exposure to dogs and dog ownership?
Have you ever had to return or remove a dog from your care because of problems with temperament or personal changes in your life? If yes, please explain.
What made you decide to purchase a Cavalier King Charles Spaniel?
Do you plan to participate in any of the following activities with your Cavalier King Charles Spaniel?
Agility Training
Breeding
Conformation Showing
Family Pet
Obedience Training
Tracking
Therapy Dog
Other
Are you aware of the health problems that are possible in this breed?
Have you read any books or articles about the breed?
Do you have a preference as to male or female?
Do you have a preference as to colour?
Black & Tan (black with tan markings)
Ruby (solid chestnut red)
Blenheim (chestnut red & white)
Tri colour (black & white with tan markings)
Are you a member of a dog breed club?
Please list a veterinary reference with telephone number.


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