____________________________________
Primary Adopter
Personal Information
Name: ___________________________________________________________________
Age: ______________
Address: _______________________________________________
Apt # ____________
City:
Home Phone: ________________________ Cell Phone: _________________________
Please include area code
Website Address:
________________________ Email Address: __________________
Place Of Employment: _____________________________________________________
Number Of Years At The Above Employment: _____________
Business Phone:
______________________________
What Hours Do You
Work: ________________________________________________
Do You Own/Rent/Lease
Your Home: _______________________
How Many Years Have
You Lived At The Above House: ___________
Who Have You Informed
That You Are Considering Bringing An
Home:________________________________________________________________________
Is Your Yard Fenced:
__________________
What Kind Of Fencing: _________________________________________________________
How Tall Is The Fence: _______________
What Is Your Marital/Relationship
Status: __________________________________
Is Your Spouse/Significant
Other Afraid Of Dogs:_______________
Do You Have Children:
______________
If Yes, How Many:
_________________
What Are The Children’s Ages: ____________________________________________
Are The Children Pet
Trained:____________________________
By pet trained, I mean are
they gentle, loving and respectful of animals
Does Anyone Within Your Home Have Allergies To Pets__________
Will There Be Any
Changes Within The Household In The Foreseen Future And If Yes, Please Explain:
(i.e.
moving to new home, new people living in your home, new baby, etc)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Does Everyone In Your
Household/Family Agree On Adopting An
Does Everyone Within Your Household/Family Agree On Raising An
Puppy:____________
General Information
Have You Ever Owned An
If Yes, How Long/What
Happened To Him/Her:__________________________________
Where did you acquire
your
Do You Own Other
Animals: _______________
If Yes, How Many:
____________
What Breed (s) /
Species And Their Ages: ________________________________________
What Gender Are Other
Dogs Within Your Household:___________
Do You Prefer A Male Or Female
Do You Intend On
Breeding This
Are You Searching For
A Show Or Pet
What Phenotype Are
You Looking For: _________________________________________
(i.e.
long coat, pinto, black mask, white face, large, American look, Japanese look)
What Activities Do
You Have Planned With Your
Where Will The
Where Will The
Will Someone Be
Available To Tend To The Puppy During Working Hours:
________
How Many Hours Will
Akita Be Home Alone: __________________
Have You Owned An
Have You Ever
Successfully House Trained A Dog Before: ________________________
Have You Ever Taken A Dog Of Any Breed To A Shelter: ___________________
If Yes, Please
Explain The Situation: _____________________________________________
_____________________________________________________________________________
Have You Ever Taken A Dog Back To A Breeder: _______________
If Yes, Please
Explain The Situation: _____________________________________________
_____________________________________________________________________________
Have You Ever Given A Dog Away: _____________
If Yes, Please
Explain The Situation: _____________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
What Do You Know
About Akitas: (please include a separate
piece of paper if needed)
Why Are You
Interested In An
What Information Have
You Read About Akitas: ________________________________
___________________________________________________________________________
How Did You Find Out
About Slip’Not Akitas: ___________________________________
Are You Willing To
Attend Obedience Classes With Your
Who Will Be Training
Your
Name Of Your Licensed Veterinarian: ___________________________________________
Telephone Number Of Your Vet: ___________________________________
Will You Be Willing
To Sign A Slip’Not
Agreement, And A Partners For Life Contract: _________________
Have You Contacted
Any Other
(optional)
If yes, Please List The Breeder (s) You’ve Contacted:
Disclaimer
The information I have
provided in this document is correct and true to the best of my knowledge and I
have not withheld any pertinent information. I understand that any
misrepresentation of myself or my family or any
untruths of the information above provided herein that are discovered at a
later date will invalidate any adoption agreement/Sales Agreement Contract and
will give Slip’Not Akitas the right to reclaim the
____________________________ _____________________
Adopter Signature
Date
Slip’Not Notes
Puppies adopted from Slip’Not Akitas are not selected for adoption until they
are 9-10 weeks old. Adopters will not know which puppies from the litter are
available until such time as Slip’Not does the litter
evaluation at 8-9 weeks of age.
Slip’Not does make a commitment to ALL approved puppy adopters
to keep in close contact, answer questions day and night, give advice and keep
adopters abreast of all decisions regarding a litter. Slip’Not
also offers a puppy pack filled with information about the litter, reading
material and helpful suggestions for training and general care. All contracts
and shipping costs must be signed and received prior to any Slip’Not
puppy leaving our kennel.
Prices for puppies are not
set until the litter has arrived. Adoption fees will not be less than $800.00
(companion) and not to exceed &1,500 (show potential) per puppy.
Please return this application to:
Slip’Not Akitas
Steve & Laurie Smith
2007
For questions or concerns, please contact us at:
785-213-5166
Slip’Not Akitas
Kennel Application
(please fill
out this page in addition if you are a
kennel or breeder of any breed of dog)
____________________________________________
Name of Kennel:
________________________________________________________________
Website Address:________________________________________________________________
How Many AKC
How Many Akitas Have You Finished To Their AKC
Championships:___________________
How Many AKC Champions Have You Produced:____________________________________
How Many Akitas Do You Own:____________________________________________________
How Many Litters A Year Do You Produce:__________________________________________
Do You Require Spay/Neuter Contracts On The Companion
Puppies You Produce:_________
Do You Require Health Testing (OFA, CERF, Thyroid) On
Your Breeding Stock:___________
Would you consider a co-ownership:______________________________
What Are Your Plans With A Slip’Not
Puppy: