Edward Wilson

354 Old Broad Cove Rd.

Portugal Cove, NL A1M 3N1 - Canada

Phone: (709) 682.6678 or (709) 895.3282

Thank you for your interest in our dogs. We would appreciate your answering the following questions
so that we can more easily test and select the right puppy/dog for you. All information is confidential.
Thank you for your cooperation and help in answering our questions.
(If no phone number is given this application shall be ignored).

Name: ________________________________ Name: ______________________________

Address: __________________________ City: __________________________ State: _____
Zip: ________ Phone: ________________ 2nd Phone: ______________ Work: ____________
Kennel Name: ______________________________________
E-mail Address: _____________________________________
Website Address: ____________________________________

Do you own any other Akitas Male / Female? _____________________________________________

If yes, how many? _______ Are they altered or intact? _____________________________________

Where did you acquire it (them)? ______________________________________________________

_________________________________________________________________________________

If you have never owned an Akita, why do you want one now? _______________________________
_________________________________________________________________________________

What types of research have you done on the Akita? _______________________________________

_________________________________________________________________________________

What are you looking for in an Akita? Show Quality or Companionship? ________________________
_________________________________________________________________________________

Do you prefer a male or female? _______________________________________________________

Please specify above: Male - Female or No Preference

What specific traits do you want in an Akita? Color, structure, Coat type (Is a Longcoat an option).
_________________________________________________________________________________
_________________________________________________________________________________

Do you intend to breed this Akita? ______________________________________________________

_________________________________________________________________________________

1
 Edward Wilson
354 Old Broad Cove Rd.
Portugal Cove, NL A1M 3N1 - Canada

Phone: (709) 682.6678 or (709) 895.3282

What type of dwelling do you live in? ___________________________________________________

Please specify- House, Condo, Apartment, or Mobile Home or other.

Do you own or rent your residence? ____________________________________________________

If you rent, does your landlord approve of an Akita? Or if you own do you have an association in your
neighborhood and do they have any issues with Akitas? _____________________________________
_________________________________________________________________________________

Do you have children? If yes, how many and their ages? ___________________________________
_________________________________________________________________________________

Do you have any other pets? If yes, what types/breeds? ____________________________________

_________________________________________________________________________________

Have you ever returned an animal from which you purchased or acquired it?
What was the reason, if yes? __________________________________________________________
_________________________________________________________________________________

Do you have a fenced dog run or yard? How tall is the fence? What are the dimensions of the run?
_________________________________________________________________________________
_________________________________________________________________________________
Please provide photos of your yard, fence and dog area.

Where will your Akita spend its time? Outside, inside the home, a run, or crate, etc.?
______________________________________________________________________________________
______________________________________________________________________________________

If you live in a state that experiences extreme summer or winter weather conditions, what type of
means do you have to care for your Akita in these conditions? ________________________________
_________________________________________________________________________________

How many hours on the average will the puppy be left alone? ________________________________
_________________________________________________________________________________

Will you allow an in home visit by Beardusk Akitas or by a representative for Beardusk Akitas, before
placement of a puppy? _______________________________________________________________
_________________________________________________________________________________

2
 Edward Wilson
354 Old Broad Cove Rd.
Portugal Cove, NL A1M 3N1 - Canada

Phone: (709) 682.6678 or (709) 895.3282

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

Are you willing and able to attend any training classes with your Akita? If yes, at what age will you
start? ____________________________________________________________________________
_________________________________________________________________________________

Have you ever bred a litter of dog? If yes, what kind and how many? _________________________
_________________________________________________________________________________

Mail back this signed application to:

Beardusk Akitas
354 Old Broad Cove Rd.
Portugal Cove, NL A1M 3N1, Canada

Please be sure to provide us with pictures of your yard, home and fencing.

Signature: _______________________________________ Date: _________

Signature: _______________________________________ Date: _________

Please use the space below and the back to add any other information you wish us to consider in
placing one of our Akitas with you. We would appreciate it if you would give us a little insight into the
expectations you may have for this new addition to your family. Thank you again – your interest is
deeply appreciated.

Edward Wilson - Beardusk Akitas