Form

Date Questionnaire Completed:*

- Month - Day Year

at

/ Hour Minutes

PLEASE NOTE: It is the responsibility of the interested buyer(s) to advise Mile High Klee Kai in writing of any changes of name, mailing address, telephone number and email address. This questionnaire becomes null and void IF Mile High Klee Kai is unsuccessful in attempts to contact interested buyer(s).

Potential Owner/Co-Owners Names:*

Potential Owner's Phone Number:*

Potential Owner's Email Address:*

Fax Number:

Potential Co-Owner's Phone Number:

Potential Co-Owner's email address:

Street Address:

City, State, Zip

How long have you lived at the address listed above?*

Do you own or rent your home?*

Own Rent Other

If you rent, have you expressed your interest in obtaining a dog with your landlord? If so, you will need to provide a letter on company letter head stating this information and we will verify*

Potential Owner's Occupation*

Employer's Name & Address*

How long have you been employed here?*

Potential Co-Owner's Occupation

Employer's Name & Address:

How long have you been employed here?

Are you 21 years of age or older?*

Yes No

PLEASE NOTE: If you are under 21, you will not be considered and if you are over 21, we will not place an AKK with you if you are in college, still live with your parents, or don't have a job.

1. How did you hear about the Alaskan Klee Kai breed?*

2. What attracts you to the Alaskan Klee Kai?*

3. Why do you think you will be a good owner to an Alaskan Klee Kai?*

4. Have you ever had the privilege of seeing an Alaskan Klee Kai in person?*

Yes No

5. How did you hear about Mile High Klee Kai Kennel?*

6. Do you have any interest in breeding your Alaskan Klee Kai?*

Yes No

PLEASE NOTE: All puppies from our litters are sold on a “pet only” contract, which means you will not be allowed to breed for any reason.

7. Will you agree to have the AKK taken to your vet at 12-months-old to have an adult exam conducted on him/her?*

Yes No

8. What will be the primary living quarters for your Alaskan Klee Kai?*

9. Do you have a securely fenced yard for your Alaskan Klee Kai and if so, please specify type, height, etc*

10. Are you willing to take your Alaskan Klee Kai to professional basic dog obedience training classes to assist you in raising your pup to be an obedient and well adjusted member of your family?*

Yes No

11. Would you consider an "older" puppy or maybe a young adult?*

Yes No Maybe

12. How many animals do you presently own? Please provide their breed and age.*

13. Are you aware that an AKK can NEVER be left off a leash to run around your front yard without a fence?*

Yes No

These little critters are quick and will bolt at any given moment if the perfect opportunity arises, so it is strongly advisable to NEVER let your AKK be off a leash even in a fenced dog park. The AKK is very brave too and will stand up to any size dog, so the owner has to be cautious in every situation during outings and socialization.

14. What dog breeds have you previously owned and what happened to the dogs you no longer own?*

15. Which breeds were you quite happy with?*

16. Which breeds were you not pleased with and why?*

17. Are you presently a dog breeder?*

Yes No

If yes: Please list all breeds that you own or co-own. Annually, how many litters do you have?

18. Have you been a dog breeder in the past?*

Yes No

If yes: What breeds were you involved with? Annually, how many litters did you have?*

19. If you have children, what are their ages?*

20. Have your children, or will your children be trained on proper treatment of a pet?*

21. Do you have any objections to us visiting your home prior to placing a puppy?*

Yes No

22. Do you agree with the philosophy of spay/neuter of family pets?*

Yes No

23. Are you willing to work with the Alaskan Klee Kai community to educate people about the Breed; honestly answering anyone’s question or by telling them where they can get answers?*

Yes No

24. Have you had any experience in showing dogs in competition?*

Yes No

25. Do you have any interest in showing your Alaskan Klee Kai in competition?*

Yes No

Please mark the area or areas you would be interested in competing:

Conformation Shows Obedience Shows Agility

26. Have you ever been convicted of animal abuse or neglect?*

Yes No

If yes, please explain:

27. Have you ever been suspended/barred from UKC/AKC privileges?*

Yes No

If yes, please explain:

28. Are you aware of the known health risks within the AKK breed?*

Yes No

Possible health risks include: Patella Luxation, Heart Murmurs, Ingrown Eyelashes, Cleft Pallets, Open Fontanel’s, Tear Duct problems, Retained Testicles, etc.

29. Any person reserving or adopting any Alaskan Klee Kai from us is required to provide two personal references that we may contact in order for you to be considered for an AKK. Please specify, if listing a friend, how long you have been acquainted. If you have been acquainted less than 5 years, please do not provide. Please provide someone with whom you have been acquainted with over 5+ years.

REFERENCE #1:

Name:*

Street Address:*

City, State, & Zip:*

Phone Number:*

Years known:*

REFERENCE #2:

Name:*

Street Address:*

City, State, & Zip:*

Phone Number:*

Years Known:*

30. Do you currently have a veterinarian that you see?*

Yes No

Veterinarian's Name:

Veterinarian's Street Address:

Veterinarian's City, State, & Zip:

Veterinarian's Phone Number:

31. If we do not have litters available can we provide your information to another breeder?*

Yes No

What puppy gender do you prefer?*

Male Female Either

Puppy color - 1st choice*

Black & white Gray & white All white (must be spayed or neutered and UKC registration papers will not be available) Any color

Puppy color - 2nd choice*

Black & white Gray & white All white (must be spayed or neutered and UKC registration papers will not be available) Any color

Eye Color Preference:*

Blue Brown Bi-eyed Any color

Adult size when puppy is grown:*

Possible Toy Possible Minature Possible Standard Any Size

Mile High Klee Kai Questionnaire