TOPSIDE Portuguese Water Dogs

Full Name:          ______________________________________________________________________________________

Address:             ______________________________________________________________________________________

Phone:                 _______________                E-mail:                _________________________________________________

Marital Status:     ________________             How many hours will puppy be alone during the day?  ________________

Place of Employment and Work Phone:        _______________________________________________________________

Children Names/Ages:           ___________________________________________________________________________

Current/Previous Pets:          ___________________________________________________________________________

Description of Home:        ______________________________________________        Do You Own or Rent?   _______

Description of Yard:  _________________________________________________________________________________

Dog Training Experience______________________________________________________________________________

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Why are you interested in a PWD?  ___________________________________________________________
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Where Will Puppy Stay During Day/Night?  ___________________________________________________
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Preferences:               Male           Female                No Preference

Hair Type:                     Curly           Wavy                   No Preference

Color or Marking Preferred:        ___________________________

Interests:                  Conformation          Obedience          Agility          Water Work           Companion

Desirable Characteristics:  ___________________________________________________________
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How did you hear about us?  ______________________________________________________________
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