YOUR INFORMATION Name: * Address: * Email Address: * Contact Number: *                     Note: ( * ) Required Are you interested in: Show/Conformation Pet/Companion Do you currently own a Siberian Husky? Yes No Are you looking for a particular coat color? Yes No What color ? Any eye color? Yes No What color ? Do you prefer? Male Female Living Arrangements? House Condominium Apartment Other Do you own your home? Yes No Do you have a backyard with a fence? Yes No Will the dog be kept inside or outside the house? Inside Outside Please provide 3 references with names and phone numbers, who we may contact regarding your ownership of a Fusion Siberian. (non-relative): Are you prepared to take responsibility for a Siberian for the next 10-15 years? Yes No Are you willing to allow us to visit your home? Yes No Please provide the name, telephone number, and address of your veterinarians. *All dogs sold as companion animals are required to be spayed /neutered. All adults are spayed /neutered prior to going to their new homes. All puppies are required to be spayed /neutered at their new owner’s expense prior to turning six months old. All dogs sold as pet/companion will be issued with PCCI LIMITED registration papers *Any Fusion Siberian that can no longer be kept by their owners must never be sold or be given away and must return to Fusion Siberians. I fully understand that completing this questionnaire is an important part of the screening process and is not a guarantee that I will be sold a Fusion Siberian Husky. Type verification code: