# 1   PLEASE ENTER YOUR NAME & ADDRESS

ALL FIELDS MUST BE FILLED IN TO SUBMIT THE FORM, THANK YOU

Name
Address
City-State
E-mail
Tel

# 2   YOUR VETERINARIANS NAME & ADDRESS

# 3   HAVE YOU EVER OWNED A NEWFOUNDLAND BEFORE?

    YES.   OR     NO.    IF YES, HOW MANY & FOR HOW LONG?

# 4   ARE YOU WANTING  A PUPPY FOR ( CHECK ONE )    A PET    SHOW RING    OR BREEDING

# 5   DO YOU OWN YOUR OWN HOUSE OR ARE YOU RENTING?     OWN    RENTING

# 6   DO YOU HAVE A FENCED IN YARD?   YES  OR   NO.

# 7   DO YOU HAVE CHILDREN?   YES  OR  NO   IF YES, WHAT ARE THEIR AGES?

# 8   DO YOU LIVE IN A 2 STORY HOUSE,   YES  OR  NO.

ALSO DO YOU  HAVE STAIRS IN YOUR HOUSE?    YES  OR    NO.

# 9   ARE YOU WANTING A    MALE OF    FEMALE?

#10   WHAT COLOR DO YOU PREFER?    BLACK     BLACK & WHITE     BROWN

#11   IS THE TERRAIN STEEP AROUND YOUR HOUSE?  YES  OR  NO.

#12   IF YOU GET A PUPPY, DO YOU HAVE AN AREA TO RAISE THE PUPPY IN FOR THE FIRST YEAR!

    THAT IS,  NO CEMENT, HARDWOOD FLOORS, LINOLEUM, OR STAIRS.    YES  OR  NO.

    PLEASE ENTER ANY COMMENTS THAT YOU HAVE ABOUT OUR WEB SITE, & WE WILL RESPOND TO ANY LEGITIMATE INQUIRE.