What is Your Full Name (First and Last) :
City :
State :
Country (if not USA) :
E Mail Address REQUIRED for reply :
How did you find our website? :
Business Card
Link From Breeder Site
Other Clumber Site
Referral By Other Breeder
Web Search
Word Of Mouth
Who are you purchasing the dog for? :
As a Gift
Myself
Our Family
What Type of Clumber Do You Want? :
Female Puppy
Male Puppy
No Preference
Unsure; I need more information
Would You Prefer Your Clumber to be: :
Lemon and White
Orange and White
Undecided
If you want a show Clumber, have you shown dogs? :
I have never shown dogs, but want to learn
I just want a pet
Yes, I've shown another breed
Yes, I've shown Clumbers
If you have shown another breed, what breed; did any of your dogs obtain their Championship? :
Are you interested in breeding your dog? :
yes no
Pets are placed on a spay/neuter agreement. Do you have a problem with this? :
yes no
If you answered yes to EITHER of the above, tell us why you may want to breed your dog. :
Have you owned Dogs Before? :
yes no
Are there pets in your home now? If so, tell us about them :
What happened to your last pet? :
What is your primary interest in adding a Clumber :
Agility Work
Hunting Dog
Hunting/Tracking Competition
Obedience Work
Pet/Companion
Show
Therapy Dog
Watch/Guard Dog
What is your main consideration when choosing a dog? :
Amount of Care/Exercise Required
Appearance
Availability
Breeder
Pedigree
Price
Do you have a fenced in yard? :
Adding One Soon
Electronic Fence
No
We have an alternative to fencing.
Yes
Which best describes your home? :
Condo/Townhouse/Apartment
House in the City
House in the Country
House in the Suburbs
Do you Own or Rent? :
Own
Rent
How long have you lived there? :
Do you have children who reside with you? How many and ages? :
Where will your dog live and/or spend most of its time? :
Inside
Other
Outside
How long will your dog be left alone each day? :
1 to 4 hours per day
4 to 6 hours per day
6 to 8 hours per day
More than 8 hours
Where will you leave the dog when it?s alone? Ex: Crate, Kennel, Confined Area/Room, Yard. :
Do you have a Veterinarian who services you have used in the past? :
yes no
If so, would you please provide his name and phone number as a reference? :
What made you decide on a Clumber? :
Friend owns one
Looks
Other
Owned one or own one now
Temperament
Watch/Guard Dog
If you chose other, please explain. :
Your expectations of your Clumber's breeder? :
Advisor
Friend
Mentor
No relationship after purchase
Salesperson only
Would you like to visit with us? :
yes no
Could we visit your home? :
yes no
When is your timeframe for bringing home a puppy? :
As soon as possible
No set time
Within 2 to 3 months
Within 3 to 6 months
Within 6 to 12 months
Have you spoken with any other Clumber Breeders, and/or are you on a waiting list? :
yes no
If yes, who? :
If we have no puppies, would you like us to share your information with other breeders? :
yes no
Please list your phone number if you prefer to be contacted by phone. :
Do you have any questions, or comments? :
Please type the text below :
