Telephone Interview Report

Date of Initial Call*

Applicant

Applicant's Name*

First Last

Address*

Street Address City State ZIP Code

Phone*

Interviewer's Name*

First Last

Phone*

For us to call with questions.

Email*

Enter Email Confirm Email

Describe Your Residential Area*

Do you own a dog?*

How Many?*

Describe Your Dog*

Has the family lost a pet?*

What Happened to It?*

Was Your Pet Spayed / Neutered?*

Are You Interested In Breeding?*

Where Do Your Dogs Stay When You Are Away?*

Family Lifestyle*

Will the Golden be Part of Your Family and Go Places With You?*

Additional Comments

Copy to interviewer