First Name Last Name Phone

Address City State Zip

E-mail

How did you first learn about Platinum Eskies? Why would you like to own a pup from us?

Do you prefer: Only Male | Only Female | Prefer Male | Prefer Female | No Preference

Would you plan to breed this dog? Yes No Maybe Would you spay or neuter your dog? Yes No Maybe

Do you have any pets now? Yes No If so what kind?

Have you ever raised a puppy? Yes No

How many people live in your household? Are their any children? Yes No If so what are their ages?

Is someone in your household home during the day? All the Time Most of the Time Some of the Time Not Much Never If not, where will your dog be kept while you are out?

Do you live in a: House Apartment Condo/Townhouse Other Where will your dog spend most of his time when he is at home?

Do you have a fenced yard or other enclosure for a dog, if so please describe?

Will you agree to provide the dog with proper housing, food and veterinary care for its lifetime? Yes No Other (explain next question)

Have you ever owned an American Eskimo before? Yes No

Have you read through our entire FAQ page on our website (including Pricing, Puppy Academy, etc...)? Yes No

Which female where you most interested in getting a puppy from? No Preference Daisy Sesi Molly

Are you going to need your puppy shipped to you? Definitely Yes Definitely No Possibly Probably No

Did you want your puppy enrolled in our Puppy Academy? Definitely Yes Definitely No Possibly Probably No

Tell us when you were desirous of getting a puppy:

Is there anything you would like us to know that hasn’t been covered in this questionnaire? Do you have any questions you’d like to ask us about Platinum Eskies or about American Eskimos in general?

Once you click Submit you will be redirected to our Home Page. Your information has been received.