Your full name:
Your email address (e.g.: yourname@aol.com):
Your phone number with area code:

Do you own or rent your home? Own Rent
Number of adults in household?
Ages? 18-30 30-65 65+
Ages of children in household?

Is anyone in your family allergic to dogs? No Yes Don't know
Is everyone in your family committed to adding an Irish Setter to the family? Yes No
If no, please explain:
Who will be the primary care giver?
Have you ever owned an Irish Setter or dog peviously? No Yes
If yes, what happened to it?

When are you looking to purchase a puppy?
What traits are you looking for in this puppy?
Are you interested in a male or female? Male Female
If that sex is not available would you consider the other? No Yes
Why?
Would you consider an older puppy or adult dog? Yes No Maybe
If yes or maybe, what is the maximum age you would consider?
< 1 year 1-2 years 2-4 years 4-6 years 6+ years

Do you have a fenced in yard or enclosure? No Yes
If no, how do you plan to control your dog? If yes, what type and height of fence?
How much exercize will this dog receive?
Where will this dog primarily spend it's time? Outside Inside Both Kennel

What is your reason for wanting an Irish Setter? Please check all that apply:
Companion
Conformation
Obedience
Field
Hunting
Breeding
Agility

How many hours per day will this dog be left alone? 1-3 3-6 6-9
If more than 6 hours, will there be a lunchtime walk?
No Yes, by a family member Yes, by a dog walker

Where will the dog be when no one is home? Loose, crated, confined to kitchen, yard, or other?

Where will the dog sleep at night? Loose, crated, confined to kitchen, yard, or other?

What would you do with the dog if you found yourself unable to keep it? (Things do happen!)


Do you currently have any other pets? No Yes
If yes, what types, ages, and temperament? Are the spayed or neutered?

Will you be spaying or neutering this dog? No Yes Depends
Please explain, are you planning on breeding?

What problems (health, behavior, training, etc) if any did you have with previous dogs?

Have you ever given a dog up to a shelter, pound or rescue group, if yes please explain?


Have you ever taken a dog to obedience class? No Yes
Do you plan on taking this puppy to obedience class? No Yes
How long do you expect house training to take?

Have you familiarized yourself with the characteristics of the Irish Setter? No Yes

How much time do you expect to do weekly on training and grooming?
< 1 hour 1-2 hours 2 -4 hours 4-6 hours 6+ hours

Are you willing to follow the Health Guidelines supplied by Roclyn Setters regarding shots, exercise and feeding? No Yes Maybe
If no or maybe, please explain:
Are you willing to stay in regular contact with Roclyn Setters for the life of the dog and provide updates? No Yes

Please provide two references (one being your vet) with phone numbers:


How do you plan for the puppy to get to you (pick up, shipping, etc)?

Anything else you would like to tell us about your family or the life your puppy would live?