Puppy Questionnaire

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=90 BGCOLOR="#000000" TEXT="#F7F7FF" background="0a0065a3.jpg"> <div> Bean Talking<FONT SIZE="1" COLOR="#000000" FACE="Arial" ><B>  </B></FONT></div> <div> <I>Where Sams Frolic</I></div> </td> </tr><tr> <td valign="top" width=210 BGCOLOR="#000000" TEXT="#F7F7FF" background="07bd1e83.jpg"> <bR> <bR> <div> <TABLE BORDER="0" CELLPADDING="2" CELLSPACING="1" WIDTH="149" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BOX" RULES="ALL" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP HEIGHT= 599 ><NOBR><div>  </div> <div> <A HREF="index.htm" TARGET="_top" TITLE="Bean Talking"><U><B>Home</B></U></A></div> <div> <A HREF="id17.htm" TARGET="_top" TITLE="About the Kennel"><U><B>About the Kennel</B></U></A></div> <div> <A HREF="id18.htm" TARGET="_top" TITLE="Gemini"><U><B>Gemini</B></U></A></div> <div> <A HREF="id69.htm" TARGET="_top" TITLE="Tauri"><U><B>Tauri</B></U></A></div> <div> <A HREF="id19.htm" TARGET="_top" TITLE="Pastel"><U><B>Pastel</B></U></A></div> <div> <A HREF="id40.htm" TARGET="_top" TITLE="Chief"><U><B>Chief</B></U></A></div> <div> <A HREF="id55.htm" TARGET="_top" TITLE="Hammer"><U><B>Hammer</B></U></A></div> <div> <A HREF="id64.htm" TARGET="_top" TITLE="Raffi"><U><B>Raffi</B></U></A></div> <div> <A HREF="id20.htm" TARGET="_top" TITLE="Contact the Kennel"><U><B>Contact Information</B></U></A></div> <div> <A HREF="id21.htm" TARGET="_top" TITLE="News"><U><B>News</B></U></A></div> <div> <A HREF="id58.htm" TARGET="_top" TITLE="Maternity Ward"><U><B>Maternity Ward</B></U></A></div> <div> <A HREF="id22.htm" TARGET="_top" TITLE="Sam Spotlights!"><U><B>Sam Spotlights</B></U></A></div> <div> <A HREF="id44.htm" TARGET="_top" TITLE="Artwork and Drawings"><U><B>Artwork</B></U></A></div> <div> <A HREF="id23.htm" TARGET="_top" TITLE="My Thanks"><U><B>My Thanks</B></U></A></div> <bR> <bR> <div> <IMG SRC="35f8b740.jpg" border=0 width="139" height="116" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <bR> <bR> <bR> </NOBR></tD> </tR> </TABLE></div> <bR> </td> <td valign="top" height=390 BGCOLOR="#FFFFFF" TEXT="#080000" background="06e07053.jpg"> <div> <TABLE BORDER="0" CELLPADDING="2" CELLSPACING="1" WIDTH="724" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BOX" RULES="ALL" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP HEIGHT= 119 WIDTH="718"><div> <B>Puppy Questionnaire</B></div> <bR> <div> If you have an interest in a puppy from Shanity Samoyeds, please fill out the questionnaire below and press the 'send' button when finished.  Thank you for your inquiry.</div> <bR> <bR> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFFF HEIGHT= 75 WIDTH="718"><div>  <form action="http://csbmail.globalscape.com/cgi-bin/csbmail/csbmail.pl" method="POST" enctype="application/x-www-form-urlencoded"><input type="hidden" name="tlx_SortOrder" value="Name,Email,House,Spay/Neuter,Family,Samoyed research,Crating,Grooming,Yard,Exercise,Male or female?,Expenses,Comments"><input type="hidden" name="tlx_FormIndex" value="2"><input type="hidden" name="tlx_OKMessage" value="Thank you for inquiring at Shanity Samoyeds. We'll be in touch soon."><input type="hidden" name="tlx_SendMode" value="1"><input type="hidden" name="tlx_Subject" value="A PUPPY QUESTIONNAIRE WAS SUBMITTED"><input type="hidden" name="tlx_EmailTo" value="shanitysams@rogers.com"> <table cellpadding="0" cellspacing="1" border="0" align="center"> <tr> <td align="left">Full Name::<br> <input type="text" name="Name" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Email Address::<br> <input type="text" name="Email" size="30" maxlength="50"></td> </tr> <tr> <td align="left">What type of housing do you reside in? (e.g. house, apartment):<br> <input type="text" name="House" size="30" maxlength="100"></td> </tr> <tr> <td align="left">How do you feel about spaying/neutering your prospective puppy?:<br> <input type="text" name="Spay/Neuter" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Who resides in your household? (including children and other pets):<br> <input type="text" name="Family" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Have you researched the Samoyed breed? Do you feel it is a good fit for your family and lifestyle?:<br> <input type="text" name="Samoyed research" size="30" maxlength="100"></td> </tr> <tr> <td align="left">What are your feelings towards crate training?:<br> <input type="text" name="Crating" size="30" maxlength="100"></td> </tr> <tr> <td align="left">What level of grooming do you think Samoyeds require? What level of grooming are you prepared to give?:<br> <input type="text" name="Grooming" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Do you have a fenced yard? If not are you willing to construct one? Do you have a pool in your yard? Approximately how large is your yard the dog will have access to?:<br> <input type="text" name="Yard" size="30" maxlength="100"></td> </tr> <tr> <td align="left">What level of exercise do you feel a Samoyed needs? What are you willing to give?:<br> <input type="text" name="Exercise" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Are you looking for a male? Female?:<br> <input type="text" name="Male or female?" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Are you prepared for the expenses of a new dog? (e.g. vaccines, proper nutrition etc):<br> <input type="text" name="Expenses" size="30" maxlength="100"></td> </tr> <tr> <td align="left">If you have any questions or comments please submit here::<br> <input type="text" name="Comments" size="30" maxlength="600"></td> </tr> <tr> <td align="right"><input type="reset"> <input type="submit" value="Send" name="tlx_send"></td> </tr> </table> </form>  </div> </tD> </tR> </TABLE></div> <bR> <bR> <bR> </td> </tr></table></body>