Questionnaire Form For:

Ancient Knight Akitas
Saratoga Springs, NY 12866


This is so that we may be able understand what you are looking for and we can tell if you have the right environment we are
looking for to place our akita in. We ask that a phone number be included . If there is no phone number you will not be
considered. Please copy this sheet and along with pictures of your house and yard send it via postal mail. Or you may use
email as well. This questionnaire is intended to help both parties. Not every puppy is suited for every home. Ex: A Hyper
Dominant puppy would not do well in a home with submissive family or a first time akita owner. As the old saying go's Burn
me once shame on you, Burn me twice Shame on Me! Placement of the right puppy to the right family can most assuredly
mean everything. If you feel we are to Intrusive please look else where and good luck in your search for you new family

What are you interested in getting?
_Puppy _older puppy _adult _Rescue

Which do you prefer?
_Male _Female

What made you decide the Akita was the dog for you?

If, I check your name and address with your local animal control, will you have been sited for anything unsafe, cruel, harmful,
neglectful, etc. to any animal?___Yes ___No

(Please be assured that I do have the right to check and will, and if found you have been sited,you will not be considered for a

Are you willing to purchase a high quality dog food? (We feed Pro Plan,but provide information on how to find a high quality
dog food if you wish to switch brands)

Have you verified your local laws on Dog Ownership and or BSL (Breed Specific Legislation)? Unfortunately these are sad
times when it has come to revoking our rights as people to own a Dog, and this is a must.

Home situation. Do you Own or Rent?
_Own _Rent
_Apartment _House _Other

If you rent , do you have permission from your landlord to have a Akita?
_Yes _No *A Letter from your landlord must be recieved and include your landlords full name address and contact number!*

Do you have children?
_Yes _No

If No, do you plan on having children in the future and will you still have space and be financially capable of taking care of your

If Yes, What are their ages?

How many people live in your home and are willing to take part in the training of said akita?

Do you or anyone living with you have allergies?

Please explain where this dog will be living? Inside Home , Outside ? Do you have a fenced in yard ,run or kennel ? If yes
could you please supply the dimensions?

How do you plan to exercise your dog? Ex: Dog parks, Walks, play in a fenced in back yard... Etc.

Do you own now, or have you owned an Akita or other dog before? Please explain below?

Your interest in this dog?
_Pet puppy
_Show puppy
_Other: Please explain:

If Pet Puppy is your interest would you consider a long haired akita?

Explain what kind of life this dog/puppy will be living and why you feel your home is suitable? Enter comments in the space
provided below:

Have you researched the akita breed,read our contracts and fully understand that it is a life time commitment owning a dog?
_Yes _No

Have you ever returned a pet to the breeder? If so, what were the circumstances?

Have you ever taken a pet to a pound or shelter? If so, what were the circumstances?

Have you ever given a pet away? If so, what were the circumstances?

Have you ever put a pet to "sleep" or euthanized? What were the circumstances?

Are you interested in competition in performance events such as obedience, agility, hunting, herding, etc.?

Are you interested in showing the dog in the conformation ring?

How would you feel about answering a small questionaire every 3mths until your pup is 1 year and then every 6mths until the
age of 2 ?

After the age of 2 it would be once to twice a year throughout the dogs life with the requirement of up to 2 photos per year. Do
you find this to be acceptable ?

How would you feel about meeting us or a Agent/Represenative of Ancient Knight Akitas if we could not?

Please provide 2 references:



Name, address and phone number of your veterinarian:

Tell us how to get in touch with you:

_Please contact me as soon as possible regarding this matter.

If you find that you have not heard from us in a 2 day span please email us or call us at :