Application application Name * Name First First Last Last Email * Phone * Address * City State Zip How did you hear about us? * How did you learn about the Shiloh Shepherd breed? * About You * adults only adults + small children adults + grown children (check all that currently apply in your home) Other Pets * currently own a Shiloh Shepherd owned a Shiloh Shepherd previously this is my first dog owned dogs previously, but none at the present dog(s) are currently in the house cat(s) are currently in the house other type pets are currently in the house (check all that currently apply in your home) About Your Home * single family home acreage apartment/condo own my home rent my home fenced yard no fenced yard, the puppy will be walked regularly (check all that currently apply) The Puppy * male female male or female, either is fine plush smooth plush or smooth, either is fine I have a color preference color is very important pet only, spay/neuter is the plan show and/or breed quality (check all that apply) Where will your puppy spend the day? Where will your puppy stay when you are at work or away from home? Where will your puppy spend the night? How many hours of the day will your puppy be left unattended? Health care & licensing * veterinarian wellness visit at least once per year keep puppy up-to-date on all vaccines screen for heartworm & use heartworm preventative keep puppy properly identified (tags/microchip) abide by all state and local laws concerning dog ownership (check all that apply) Veterinarian's name and contact info: Formal training, etc. puppy classes basic obedience advanced obedience agility search & rescue therapy/assistance herding other (check all that apply) Breeder Relationship * * agree to return Shiloh to Orchard Hills Shilohs should you be unable to keep it agree to provide regular follow up reports on the health & well being of your puppy (check all that apply) References * list 3 references (2 if you would like to count your veterinarian listed above); include complete names, addresses, telephone numbers, and emails. Reference #2 * Reference #3 Additional Comments Submission By submitting this application, you agree to authorize the veterinarian listed above to release information to Orchard Hills Shilohs. Should your application be accepted, a DEPOSIT will be required. Thank you for your interest in Orchard Hills Shilohs! If you are human, leave this field blank. Submit