Prospective Dog Owner's Questionnaire

Name: Address: City: State: Zip: Home Phone: Cell Phone : E Mail :

Why are you interested in owning a Coton?

How did you find us?

Describe your living arrangement (home, apt., other):

What percentage of the time will your coton be inside?

What percentage of the time will your coton be outside?

How many hours away from home are you each day?

Where will your Coton be during this time?

Will your Coton be left alone?

How will your Coton be cared for when you go on vacation?

Do you have a fenced yard? Is it secured?

Do you intend to train your Coton? If so how?

Where will your Coton sleep?

Do you have children? What are their ages? How do they feel about owning a Coton?

Have you owned any dogs previously? If so what breed(s)?

What happened to these dogs?

Prospective Dog Owner's Questionnaire for Tom Rimmer & Young At Heart Cotons.com Page 1 of 2 Do you currently own any dogs? How many? Describe their temperaments. Are they spayed or neutered?

Do you have a preference for a male Coton or a female Coton? Why?

Do you prefer an all white, or a tricolored Coton?

Describe your preferences with respect to gender, temperament, color or markings, and size.

Describe why you want a Coton... Is the reason companionship, show, obedience, breeding, etc. Please explain.

Do you plan to spay or neuter your Coton? Why or why not?

Please add any questions or concerns you have for me.

Thanks for completing this questionnaire.I hope to match you with the just the right Coton! Tom Rimmer

Prospective Dog Owner's Questionnaire for Tom Rimmer & Young At Heart Cotons.com Page 2 of 2