Name: * Street Address: City: State: - - Choose One - - AL AK AZ AR CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip Code: Phone: Email Address: * Living Arrangment: Married Living together Single Single with roommates Other If Other, please explain: If you have children, what are their ages? House Arrangements: Own home Own condo Rent house Rent apartment Other If Other, please explain: If renting, does the landlord allow pets? Yes No Not sure Do you have a fenced in yard? If not how will the puppy be exercised? Does everyone in the household want a Samoyed? Yes No Not sure Is someone home during the day? If not how will the puppy be exercised? Are you willing to get a dog walker if you are not home during the day? Yes No Not sure Puppies do need playtime!! Do you live in a dog friendly area? Please explain: Why the Samoyed Breed? Have you ever owned a samoyed? If yes, please explain: Samoyeds are a double coated breed, they do shed. Please tell me a little about your lifestyle: Questions or Comments: Security Code * We love our dogs and we want the BEST for each puppy/dog we place. Samoyeds are sweet and loving animals, please treat them as part of your family. We would not have it any other way! Thank you for your interest in Mystic Oz Samoyeds where Samoyeds always smile!!!!