Belleville Ontario
(613) 477-1844


In order for us to help you select the right dog for your specific needs
PLEASE ANSWER THE FOLLOWING QUESTIONS THE BEST YOU CAN. Although these questions may seem personal they are important.

Name: (required)*

E-mail Address: (required)*

(required; enter mobile phone here if that is your preference)*


City, Province/State, Postal Code/ZIP:


How did you hear of us?

Where and when did you discover the Shiloh Shepherd?

I am interested in a Coat Type: in this color:

The temperament I expect from my dog, as per the following possibilities would be:

a) the mailman knocks at the door with a package delivery, I want my dog to:

if other, explain

b) my dog and I are taking a walk in the park and I see some old friends; I want my dog to

if other, explain

My dog will spend most of his/her time:

if other, explain

I am interested in training my dog in:

I am interested in show/breeding:

I am interested in a pet and plan to spay/neuter:

Do you have any dogs currently in your household?
If so, please state what breed, age and gender:

Have you owned dogs in the past?
they were

My household consists of number of adults, number of children and other pets (please list all)

The ages of the adults in my household are:

list the ages of current children:

do you expect to have children?

Please supply two references and contact numbers:

Any comments you may have that may help us choose the correct temperament pup for you (ie. Lifestyle: runner, hiker, etc) would be appreciated. Please tell us about your plans to socialize your pup and any experience you have with dogs.

Feel free to contact us for more information.

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