People Questions
Last Name:
First Name:
E-Mail Address:
Street Address:
City:
State:
ZIP:
Home Phone
Work Phone
Occupation
Canine Questions
Sex of dog you are interested in:	Not Sure Male Female
Color of dog you are interested in:	Not Sure Blenhiem (Brown & White) Tri Color (Black, White and Brown) Ruby (Solid Brown) Black & Tan (Black & Brown)
Do you have a fenced yard?	Yes No
If not how will you exercise your dog?
Do you own dogs of other breeds?	Yes No
If yes, please list the breeds:
Where will your Cavalier spend the day?
Where will your Cavalier spend the day?
Do you have a regular veterinarian?	Yes No
Name, Address and phone number of your veterinarian:
Do you understand that you are expected to spay or neuter your Cavalier in order to receive your registration papers?	Yes No
Do you agree to contact Mountain Cavaliers if you can no longer keep or care for your cavalier?	Yes No
All of the information that I have given above is true and correct. I agree to provide proper and sufficient food, water, shelter, training, medical care, companionship and humane treatment at all times. Type your name if you agree:
Date:
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