First Name(s):
Last Name(s):
Please check this box if you resent
filling out this form
Street Address:
City:
St.
Zip:
E-mail 1: (req)
Phone: (req)
From the list below please select the
breed or breeds (cntrl+click) that you think are most similar to GSMDs
E-Mail 2:
Phone 2:
Saint Bernard
Rottweiler
Saluki
German Shepard
Bernese Mt Dog
Mastiff
Pit Bull
Rhodesian Ridgeback
Miniature Bull Terrier
Otterhound
Kuvaszok
Please list the name and age of all
Please list the species, breed, sex
and age
Please Check All That Apply
I have owned a dog before .
Please list any outdoor animals
Please list all of the dogs you have
ever owned. If deceased note life span and cause of death.
I have raised a puppy.
I am a GSMDCA member.
I have owned a Swissy.
Please list the character traits you
Please list the household activities
that your pets
I have met a Swissy.
I want a male puppy.
I want a female puppy.
Please describe the property both
Please describe the occupations of the
people responsible for the household and the time available to raise
a puppy.
I want an adult Swissy
I want a companion.
I want to show.
From the list below please select the
price that you consider reasonable for a GSMD puppy.
From the list below please select the
breed or breeds (cntrl+click) that you would NEVER consider owning
I want to breed.
$0.00 to $300.00
$301.00 to $600.00
$601.00 to $900.00
$901.00 to $1,200.00
$1,201.00 to $1,500.00
$1,501.00 to $1,800.00
$1,801.00 to $2,100.00
$2,101.00 to $2,400.00
$2,401.00 to $2,700.00
$2,701.00 to $3,000.00
Pit Bull
Chihuahua
Great Dane
Rottweiler
Rhodesian Ridgeback
Poodle
Belgian Malinois
Newfoundland
Old English Sheepdog
Alaskan Malamute
Giant Schnauzer
Weimaraner
Saint Bernard
Doberman Pinscher
None of the above
I have crate trained a puppy.
I subscribe to the Swissy-L
I have visited www.gsmdca.org
From the list below please
select the maximum you would pay to save the life or significantly improve
the quality of life of a GSMD.
From the list below please
select the annual amount that you would consider reasonable to feed
and care for a GSMD.
My pets sleep in bed with me.
My pets are allowed on the furniture.
$500.00
$1,000.00
$2,000.00
$3,000.00
$4,000.00
$5,000.00
$6,000.00
$7,000.00
$8,000.00
$9,000.00
$10,000.00
More Than $10,000.00
$500.00
$750.00
$1,000.00
$1,250.00
$1,500.00
$1,750.00
$2,000.00
$2,250.00
$2,500.00
I need a dog to protect me.
I own a book about dog training.
My pets go on vacation with me.
From the list below please
select the activities (cntrl+click) which you are interested in doing
with a GSMD
From the list below please
select the health problems (cntrl+click) which you have learned can
affect some GSMDs
My pets go to day care.
If my pet is put to sleep I want to
be in the room.
Conformation
Agility
Weight Pulling
Obedience
Drafting
Tracking
Backpacking
Search And Rescue
Therapy
None of the above
Corn Cobb Disease
Osteochondrosis Dissecans
Bloat
Hip Displaisia
Progressive Retinal Atrophy
Incontinence
Cancer
Spleenic Torsion
Elbow Displaisia
Gastric Dilatation-Volvulus
Epilepsy
Von Hildebrand’s Disease
I will let my dog kiss me on the lips.
I can punish my pet if it deserves it.
If my pet does something wrong it is
my fault.
From the list below please
select the the time frame within which you are hoping to get a GSMD
puppy.
From the list below please
select the way in which you prefer to get your puppy
I live within 1 hour of a 24 hour emergency
animal hospital.
I will pay $40.00 a month for health
insurance for my pet.
Now to 3 months.
3 months to 6 months
6 months to 9 months
9 months to 12 months
12 months to 15 months
15 months to 18 months
18 months to 21 months
21 months to 24 months
Drive to pick up
Fly to pick up
Puppy must be shipped
Pay breeder to deliver
Have friend / family pick up
My pets are inside when I am at work.
There will be someone home with my
pet most of the day.
My pets are inside at night.
Please add any additional information
that you feel we should know in the field below.
Thank you for filling out our survey.
We will be in touch within a few days.
