The following questions are intended to help BelleRaine Goldens decide if one of our puppies might be right for your family. They also help you to think about what owning a golden entails. Goldens are not for everyone! Your answers will NOT be used against you in any way, so please be frank and thorough.

***If you are chosen for one of our puppies, a copy of this questionnaire must be printed out and mailed along with your deposit.

Name: __________________________________

Address: _______________________________

_______________________________

Phone #: ______________________________

Email address: _______________________

Names and ages of other family members:

________________________________________________________________________

1. How did you hear about BelleRaine Goldens (referral from Belleraine puppy owner, referral from veterinarian, referral from another breeder, Internet Search Engine, Breeders.net, newspaper, AKC website, etc).

2. Will this be your first golden?

3. What interested you in our goldens?

4. What qualities are you looking for in your next dog?

5. What qualities are you trying to avoid in your next dog?

6. Do you expect your golden to be energetic, a lazy couch potato or both?

7. Where will your golden live(inside, outside, a combination of both, etc.)

8. How long do you think it takes to housetrain a puppy?

9. How will you “correct” your puppy's negative behavior?

10.Will you attend puppy kindergarten (training classes)?

11.How much time do you plan to spend interacting with your golden each day?

12. Who will care for your golden when you are traveling?

13. Who will be the primary caregiver?

14. Does everyone in the household want this dog? Will everyone be willing to help out with housebreaking, training, etc.?

15. Is anyone in the house allergic to dogs? Afraid of dogs?

16. If you are in the military, do you have any plans to be transferred?

17. What would you do if you had to relocate and “can’t take the dog?” If this should ever happen due to unforseen circumstances, do you agree to notify Belleraine Goldens so that we may take back the dog/puppy or allow help find him/her an appropriate home?

___________ (buyer's initials)

18. What brand of food do you plan on feeding?

19. Are you aware that the cost of veterinary care can be very expensive and often unexpected?

20. Do you understand that BelleRaine Goldens has performed tests on their breeding dogs recommended by the parent club to help ensure the resulting puppies’ good health, but that we are unable to guarantee your puppy won’t have any problems during its life?

___________ (buyer's initials)

21. Are you aware that BelleRaine Goldens sells pet puppies with either UKC or AKC Limited Registrations, and that we require by contract that these puppies be spayed or neutered by 9 months of age?

___________ (buyer's initials)

22. Are you willing to supervise ALL play time between your puppy and children under 9 years old (or older if necessary)?

23. Do you have other pets? Please describe.

24. What has happened to previous pets?

25. When do you plan to add a golden to your family?

26. Do you have a sex preference (male, female)? Why?

27. Is there anything else you would like to add?

28. I understand that my deposit is refundable only if Belleraine Goldens cannot provide me with a puppy of my sex and litter preference (stated at time of deposit).

___________ (buyer's initials)

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(Buyer's signature)

Thank you for taking time to answer our questions. We look forward to answering any you may have for us!