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* 1. Contact Information

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* 2. Are you 18 years of age or older?

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* 3. Kennel Name (if applicable)

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* 4. What is your dog's breed?

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* 5. Date of Whelp

Date

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* 6. Is your dog AKC registered?

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* 7. Are you a member of an AKC dog club? 

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* 8. If so to what AKC club(s) do you belong?

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* 9. Do you breed more for: Performance, Conformation and/or attempt to find balance between Performance and Conformation?

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* 10. Are you actively participating in sporting dog events?

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* 11. Have you previously trained a dog for:

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* 12. Do you have any other information you would like to share?

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