Nova Scotia Duck Tolling Retrievers

A Kingston, Ontario, based breeder for Rideau Kennels

Questionnaire

If you are interested in being put on a waiting list please fill out this questionnaire. Please include as much information as you can. This information is collected in accordance with our privacy statement and will not be used for any other purpose than to contact you when we have planned a litter.

* = Asterisks denote a required field

Family Information

* Family Last Name:

* Adult Residents:

Name: Occupation:

Children:

Name: Age:

Contact Information

* Phone:

* E-mail Address:

Address:

City:

Postal Code:

Household Information

House Type:

Do you own/rent?

Where will the dog live?

Where will the dog sleep?

Yes: No:

Is everyone in the household in agreement about getting a Toller puppy?

Yes: No:

Does anyone smoke in the home?

Yes: No:

Is your yard fully fenced?

Neighbourhood Information

Yes: No:

Are there dog-friendly parks or open spaces near by?

Yes: No:

Do you live near/have access to a river or lake?

Preference Information

When do you hope to get a puppy?

Do you prefer a male or female?

History Information

Yes: No:

Do you have or have you had a dog before?

Yes: No:

Have you ever had to turn a dog over to the Humane Society?

Ongoing Care Information

Yes: No:

Are you willing to feed the food recommended?

Yes: No:

Are you willing to vaccine your dog?

Yes: No:

Do you realize Tollers are high-energy dogs?

Yes: No:

Do you plan to take basic obedience classes with your dog?

Yes: No:

Do you plan to crate/kennel train your puppy?

What activities do you plan to do with your dog?

Pet Only	Obedience Competition
Agility / Flyball	Field Competition
Conformation Showing	Hunting Companion
Other:

Summary

How did you learn about Tollers and us?