| Please fill out as much information as possible! We will use these informations to try to fulfill your request! |
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| Your name: |
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| Home phone number: |
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| Business phone number: |
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| Cell phone number: |
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| E-mail: |
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| Address: |
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| City: |
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| Zip: |
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| State: |
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| Your age: |
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Age of your spouse
(if applicable): |
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Age of your children
(if applicable): |
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Your occupation: |
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Your spouse's occupation
(if applicable): |
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| You or your family's previous dog training/handling experience: |
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| Who will be the dog's primary handler? |
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| Where do you live? |
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| Your favorite activities: |
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| Please rate your physical conditioning. Be honest! |
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| Do you or your family have any allergies? If yes, please explain |
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| Do you travel often? If yes, what is the average length of absence? |
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| Has your life ever been threatened? If yes, please explain. |
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Do you possess firearms for self-defense? |
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| Do you speak a language other than English? If yes, which language? |
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| Do you have other pets? If yes, please describe. |
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| * Briefly, explain your primary motive for purchasing a protection dog.We hope you do not find these questions intrusive. They are important in the K9 placement process, but do not answer any questions you are concerned with. |
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| * Enter the verification code |
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