Name First Last Email Address Phone Number Street Address City State ZIP Code Please list everyone living in your household and their approximate ages Do all members of your household want this dog? Yes — everyone is on board Mostly, with some reservations Not all members are enthusiastic Do you have other pets? (please include species, breed, name, age, sex, and whether intact or not) Describe your home and living situation (house/apartment, do you have a yard, is it fenced?) How many hours per day would the dog be left alone? Where do you plan to have the puppy sleep? Tell us about your experience with dogs Have you ever owned a Toller before? Yes No Have you ever surrendered a dog to a shelter, rescue, or back to a breeder? Yes No If yes, please explain Veterinarian Name Veterinarian Phone Number Why do you want a Nova Scotia Duck Tolling Retriever? Why Paradise Tollers? Are you considering any other breeds? Yes No — Tollers are my first choice If yes, which breeds? Are you on a waitlist with any other Toller breeders? Yes No If yes, which breeders? Do you have a sex preference? Male Female No preference What are you looking for in a puppy? (check all that apply) Pet Hunting Dog Conformation Obedience Rally Barn Hunt Fast Cat Dock Diving Scent Work Agility When are you looking to add a Toller to your family? Are you or anyone in your household planning to get another puppy in the next year? Yes No What training classes or plan do you have in mind for your puppy? Is there anything else you'd like us to know?
