Carroll's Klee Kai Owner Information Form

CARROLL'S KLEE KAI
WACO WINN LINE
51 Katies Ln.
Washougal, WA 98671
(360) 837-1429

KLEE KAI PERSPECTIVE OWNER INFORMATION FORM

Name(s)_________________________________________________________________
e-mail Address___________________________________________________________
Street Address____________________________________________________________
________________________________________________________________________
City, . . . . . . . . . . . .State, . . . Zip
(_____)___________________________
Phone
Occupation_________________________________________

Please understand that you must answer all of the following questions in order to be approved to adopt one of my Klee Kai.

How long have you lived in the area?____
Do you plan to move in the next 2 years?____
If yes, have you considered that finding a new place to live can sometimes pose a problem when you have a pet of any kind?
So, if you plan on moving, what plans do you have to be sure your Klee Kai will be a permanent member of your family?
Do all heads of household agree on this purchase and breed of dog.
Number of children in household____________?
Ages of Children?_______, ___________, ___________
If yes, have the children had any experience with animals?____
If no, how do you plan to socialize this puppy to make him/her a good citizen? Answer on back.
Any other pets in the home?__________
If yes, what kind and your plans for integrating your new puppy with the other animals in the house hold.
Do you own (__) a house (__), trailer (__), a condo (__)?
or do you rent (__) a house (__), trailer (__), a condo (__), an apartment (__)?
What kind of exercise area do you have, i.e., a fenced yard?________________
What is your plan to provide exercise and training for your Klee Kai.
Have you had a dog before? (___)yes (___)no If yes, what kind of dog and what happened to it.
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

In case of the owner(s) death(s) this Klee Kai will:
1. (___)be kept by a family member or friend whose name, address and phone number are as follows:
Name_______________________
Address__________________________________________________________
_________________________________________________________________
City State ZIP Code
Phone number__________________

2. (___)be placed in a new home by a family member or friend as indicated above.

3. (___)be returned to the breeder for placement in a new home.

Wherever this Klee Kai is placed, the Breeder must be informed of the new owner's name, address and phone number.

PERSONAL REFERENCES

Any person reserving or adopting any Klee Kai is required to fill out this personal information.

Name of personal reference_________________________________________
Address_________________________________________________________
______________________________________________________
City State ZIP Code
(___)_______________
Phone

KLEE KAI PERSPECTIVE OWNER INFORMATION FORM

PERSONAL REFERENCES

___________________
Signature(s) of applicant
_
Date

Klee Kai National Kennel Club

KLEE KAI PERSPECTIVE OWNER INFORMATION FORM

PERSONAL REFERENCES

_______________________________________ Signature(s) of applicant _____________________ Date

Klee Kai National Kennel Club

___________________
Signature(s) of applicant
_
Date