Breeders Term Questionnaire Breeders Term Questionnaire The information provided here MUST MATCH the information we will find on your license and background report. Name * Name First Name First Name Last Name Last Name Birthdate * Phone * Email * Address * Address Address Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal If you have ANY other animals that share the same property please list them here with their breeds, are they intact, and ages: Do you have children that will share the home with the dog full time or part time? * Yes No Have you had a Doberman before? * Yes No Do you own or rent? * Rent Own Which gender are you looking to foster? * Male Female Do you understand you are REQUIRED to have this foster dog obedience trained? * Yes No Will you be using the breeders term dog as a working dog? * Yes No Will you be interested in pursuing AKC titles with the dog? * Yes No Do you currently have a vet? * Option 1 Option 2 What best describes your housing situation: * Single Family Home Mobile Home Park FarmFarm Condo/Apartment Townhome Average daily time the dog would be alone? * >4 hours 5-8 hours 8-12 hours In your own words please explain your understanding of the breeders term program: * Your Current Vet Name: Current Vet Phone: Describe your homes fencing, if any: Describe your plan to raise and train the dog if approved: * Reference Name 1: Relationship: Phone Reference Name 2: Relationship: Phone Reference Name 3: Relationship: Phone Submit If you are human, leave this field blank.
