Date: (MM/DD/YYYY)

General Information:

Personal Information:   (fields marked with * are required)

Name: (you)

Name: (spouse/other)

Street Address:

City:

State:

        * Zip:  

Phone (home):

Phone (mobile):

E-Mail:

Age:

Occupation:

Children at home?

Yes   No      Age(s):

Please take this opportunity to tell us more about you and your family.

Please provide two personal references and their contact info:

1.
2.

Property Details:   (fields marked with * are required)

*

In what type of area is your home located?

*

What type of home do you live in?

*

Do you rent or own
your home?

Own Rent Other     Other?

If you rent, what would you do with your dog if you had to move?

*

What is the size of your property?

Average Lot (under .5 acre) Spacious Lot (.5 to 1 acre) Small Acreage (1 - 10 acres) Large Acreage (10+ acres) Not Applicable

Additional description:

 

*

Do you have a fenced area in your yard?

Yes No Planning To If yes, please describe:
 

Ownership:   (fields marked with * are required)

Do you currently own or have previously owned dogs?

Yes No

Vaccinated for...

Brand of food fed?

Free Choice (food out at all times) Meal (one portioned meal per day) Meals (two or more portioned meals per day) Not Applicable

Do you currently have any pets at home? 

Yes No

If so, what species? (If dogs, please specify the breed).

Are you planning to spay or neuter this dog?

Yes No Undecided

If no or undecided, please explain why: (required)

Will this dog live primarily inside or outside?

If outside only or both indoors and outdoors or other, please describe outside/other living conditions.

Kennel Run Fenced Yard Other Not Applicable

Please describe:

Where will the dog be when you are NOT home?
 

Where will the dog be when you are at home?
 

Do you plan to train this dog?
 

What types of training will you do?

(Please check all that apply)

Hunting

Field Trials

Obedience

Other    

Do you have any dog training experience?

Yes No If yes, please explain:

Breed Related:

Would this dog be your first Llewellin Setter?

Yes No Owned an English Setter

What qualities are you looking for
in a dog?

What are the reasons you have chosen a Llewellin Setter?

(Please check all that apply)

Family Companion

Hunting

Field Trials

Breeding

Show Ring
 

Hunting Background:

Are you an upland hunter?

Yes No

What upland birds do you hunt?

Are you a member of any hunt club / bird preserve or training facility?   Yes No

If yes, please describe:

What other breeds have you hunted with?

Puppy Preferences:

If you want to reserve a pup from one of our current or future litters, please tell us your preferences.

Color:

Any color, No preference

(Select from below if you have specific color preferences)

White / Black and ticked

White / Orange and ticked

White / Chestnut and ticked

Tri-color (White / Black / Tan)

Chestnut Tri-color (White/Chestnut/Tan)

Blue Belton

Orange Belton

Chestnut Belton

Tri-Belton

Chestnut Tri-Belton

If you have indicated a specific Litter ID or have no preference for parentage, you may leave this blank.

Sire: 
Dam:
 

Delivery Method:

See Methods

Pick-Up in Person at Hickory Hollow Air Shipment Personal Delivery Other

If Air Shipment, Personal Delivery, or Other, please indicate where the delivery will be made, specifically airport information when applicable.

Additional Puppy Preferences:
 

(list any specifics or deal-breakers here)

Puppy Extras: