Please answer the following questions as accurately as possible, so that we can match your family with just the right Shiloh Shepherd.

Name: Email Address:


City: State: Zip: Country:

Home Phone: Work Phone: How did you hear of us?

1. In what type of housing do you reside?

2. Do you live: if Farm/Ranch, how many acres?

3. Do you

If you rent, does your landlord permit dogs? yes no

Would you permit us to contact your landlord? yes no

Landlord's name and phone number:

4. Do you have a fenced yard? yes (in feet) and type no

If none, explain in detail how your dog will be exercised and pottied each day:

5. My household consists of the following number of: Adults Children dogs cats other

My children's ages: Adult ages:

My dogs are (list age, sex and breed):

6. I have owned dogs in the past

7. My dogs were: because:

other reasons:

8. Do you currently particiapte in canine activities? yes no If so, what kind:

9. How did you find the Shiloh Shepherd Breed?

if other, please explain

10. What characteristics of the Shiloh Shepherd are best suited for your family?

11. What are your plans for this dog?

12. Are you willing to follow the guidelines involving positive reinforcement when training this dog? yes no

13. How might your current situation change in the next 5 years?

the next ten years?

14. Shiloh Shepherds are a significant investment, what do you expect for the purchase price of a Shiloh?

15. Please describe a typical schedule on a weekday and on the weekend:

16. I would like a:

17. I would like a:

18. I would like a:

19. How flexible are you in your preferences?

20. Would you be willing to Raw Feed? yes no

Please describe your immediate reaction to the following situations:

21. Dog potties in the house within the first three weeks of arrival:

22. Dog potties in the house within the first six months of arrival:

23. Dog chews on child's toy or furniture:

24. Are you willing to:

25. Please list 3 references. Please include complete names, addresses and telephone numbers:




Any further questions and/or comments you may have can be included with this application. Please make your comments below:

Feel free to contact us for more information.

Thank you for your interest in Rising Star Shilohs.

If you prefer to download Puppy Application in either MSWord or PDF format, please return to the address noted on the form.