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Questionnaire for Prospective Owners
Thank you for inquiring about obtaining a Golden Gait English Cocker Spaniel.  When we breed a litter, we make it our highest priority to ensure we place our puppies into loving, committed homes.  Furthermore, we believe not every puppy is the right "match" for every household. Therefore, in an effort to try to place our puppies in the best homes possible that are the best match for both the puppy and the new owners, we ask every prospective owner to first complete this questionnaire.  This questionnaire helps us to get better acquainted with you and your household dynamics, as well as your expectations and desires for your new puppy.  There are no right or wrong answers, nor will your answers be the sole determinant of whether or not a puppy will be made available to you.  It is simply a starting point for us to get to know you better as we consider you as a forever home for one of our precious puppies.  Thank you, and we look forward to talking with your further.
Debbie Owczarzak

  1. Please provide the following contact information:
    Street Address
    Address (cont.)
    Zip/Postal Code
    Alternate Phone
    Home Phone
  2. What is your age range?

  3. How many adults in your household?

  4. How many children in your household?

  5. What are the ages of the children living with you?
    (hold down Shift Key to select multiple items)


  6. Do you have any other dogs?

    Yes No

  7. If Yes to Question #6, please list breed, age, and sex of other dogs living with you.

  8. How did you learn of the English Cocker Spaniel?

  9. Describe your ideal dog. (what you are looking for)

  10. Do you have a fenced yard?

    Yes No

  11. What is your color preference, if any?

    No preference

  12. Do you prefer Male or Female?

    No Preference

  13. Why do you prefer a Male or Female?

  14. Are you looking for a puppy, adult, or either if it is a good fit for you?

  15. Other than being a family pet, what other activities do you want to do with your pet, if any.

    Conformation Showing Obedience Agility Hunting Breeding

  16. Do you currently have a Veterinarian?

    Yes No

  17. If Yes to #16, as a reference, please provide contact information for your Vet.


  18. Is there anything else you want to share about yourself or your household situation?

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