Kim Wallace-Schall
KiMar Keeshond
1080 Hilltop Drive
Duncansville, PA  16635
(814) 935-3676
E-Mail- KiMarKees@msn.com
Puppy Application

This application is to provide us with contact information, so we can discuss further
your interest in a KiMar puppy. Submitting this form does not obligate you to
purchase a puppy, nor does it guarantee that we will have a puppy for you.
Name:  
Street Address:
City:
State:
Zip Code:
Home Phone:
Cell Phone:
E-Mail Address:
Referred By:
Do you prefer a Male or Female puppy?
Do you plan on training and/or competing in any of the below events?
o        Obedience
o        Rally
o        Agility
o        Confirmation
o        Other-Please explain

Have you owned prior Keeshonden, if so where were they purchased?

If not, why have you chosen this breed?


Do you currently own any dogs? (Breed and Ages)


Is your yard fenced (what kind of fencing)? If not, how will you provide exercise to puppy?


Do you own or rent your home?


Number of adults and children (Ages) living in your home.



Name and address of your Veterinarian.
TO SUBMIT:

COPY AND PASTE ONTO
E-MAIL

Complete the form on E-Mail then  
          send to

E-Mail- KiMarKees@msn.com
If you do not receive a
response back from us
within one week.
Please call or e-mail me.