Date   

Please contact me about Niki upcoming litters older puppies/dogs available                                                                                                

Name  

Address   

City   State    Zip 

Home Phone   Business Phone 

Email   

Occupation  

I am interested in a: black/yellow , male/female Labrador Retriever puppy/adult for: a family pet/companion, showing, breeding, obedience, hunting, service work, agility, or tracking

Have you previously owned a Labrador Retriever? 

How many dogs do you own at the present time? 

Where will the dog spend most of its time? 

Do you have a fenced yard?  

Do you have a kennel run?   

Is there somebody home during the day to care for the dog?   

How many hours per day would the dog be left alone?

Is anyone in your family allergic to dogs or dog hair?       

Name of spouse 

Number of children   

Ages:   

Referred by 

Veterinarian 

Veterinarian Phone Number

Other Information: 

Thank you in advance for your patience in filling out my questionnaire and for your interest in BarnSwallow Labradors .