| Full Name-- |
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| Street Address-- |
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| City, State-- |
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| Zip-- |
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| Phone-- |
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| Email Address-- |
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| Where did you hear about Silken Windhounds? How did you find Kohana?-- |
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| Please list your household members their ages and occupation(s)-- |
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| Do you (or significant other) work...At home or Out side the home?-- |
You At Home
You Outside the Home
Significant Other At Home
Significant Other Outside the Home
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| If need be explain work situations-- |
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| The house is empty for how many hours during the day-- |
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| Where will your Silken spend it's day time hours-- |
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| Where will your Silken spend it's night time hours?-- |
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| Describe residence, House, Appartment? Yard? Fenced - how high, not fenced?-- |
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| If you do not have a yard how do you plan to excercise your Silken and how often?-- |
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| Do you own any dogs now and if so please describe what kind and age?-- |
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| If you are interested in a companion do you plan to spay/neuter your Silken?-- |
Yes
No
Not Sure
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| Will you be breeding this Silken? |
Yes
No
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| What activities would you like to share with your Silken? Check all the following that applies-- |
Showing/Confirmation
Agility
Lure Coursing
Racing
Obiedence Training/Competition
Therapy Work
Breeding/Raising Silkens
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| If for whatever reason, you are no longer able to care for your Silken, do you agree to contact me & return the Silken to me?-- |
Yes
No
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| Do you have a preference Male or Female? Color?-- |
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| Please tell us why you would like a Silken and why you think your home would be a perfect match-- |
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