Silvercreek Chesapeakes - Interest Form

Thank you for your interest in Silvercreek Chesapeakes. We appreciate your interest and to help us know you better and pick the right puppy for your, please take a few minutes to complete the following questionnaire.

All information is strictly confidential.

Name: (required)

Address:


Phone:
Cell Phone:
e-Mail:

Occupants in the household and ages :
Adults
Children

How did you hear about Silvercreek Chesapeakes?

Are you familiar with the Chesapeake Bay Retriever? Yes No Owned
If No, have you had the opportunity to see an adult Chesapeake in person? Yes   No

What sex are you looking for? FEMALE   MALE   EITHER

What color are you looking for?

How soon are you looking for a new puppy?

What do you want this new puppy for? Companion/Pet   Conformation/Show   Obedience   Hunting   Agility   Field Trials   Pet Therapy   Breeding
If for breeding, are you willing to work with the breeder? Yes   No
If NO, why?

Is this your first dog? Yes   No   If No, what was the breed?
If No, and it is no longer living, how did it die? Natural   Heredity Disease
Other

To what level did you train your dog? KPT   Beginners   Competition

Do you presently own any dogs? Yes   No
If yes, how many and their ages?

Are they intact or altered?    Have you breed them?

If you have bred, did the sire and dam have the ORA and CERFs? Yes   No
If NO, please explain why?

Have you put any titles on them?

Are you planning on taking this new puppy to obedience school? Yes   No
If NO, why?
Do you need the name of a local obedience school in your area? Yes   No

What training methods do you plan on using on your new puppy? Food   Praise Collar Corrections   Other

Do you live in the? City   Suburbs   Rural

Is your property fenced and secured? Yes   No    If NO, are you willing to fence Yes   No

Where will the dog stay during the day?
Where will the dog stay during the night?

Do you own a dog crate? Yes   No   If NO, are you willing to to buy one? Yes   No
If NO, why?

Will someone be home during the day for the puppy?

What is your outdoor activity level None   Some   Active   Very Active

If you can no longer keep or care for the dog, what would be your plans? Return to Breeder   Place with a family member   Contact CBR Rescue   Turn into the SPCA

Additional Comments

We appreciate and thank you for taking the time to fill out this questionnaire and giving us the insight into the type of Chesapeake you are looking to add to your family.

Silvercreek Chesapeakes
412 Woodbury Drive, Wyckoff, NJ 07481
(Days)201-848-9229 (Home) 201-891-5090 (Fax) 201-848-8525
silverck@carroll.com

Home of the All Purpose Chesapeakes