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Name (Optional) : Gender: Address: Civil Status: Age: Source of Income
Name (Optional) : Gender: Address: Civil Status: Age: Source of Income
Name(Optional): Gender:
Address: Civil Status:
Age:
Source of Income
( ) Allowance
( ) Salary
( ) Income from business
Others, please specify: _________________
3. What are the breed/s and gender of your pet? Check your answer/s.
DOG BREEDS M F
Shih Tzu
Poodle
Siberian Husky
Chihuahua
Chow Chow
Labrador
Pug
Golden Retriever Others, please specify: ____________
Dalmatian
German Shepherd
Askal/Aspin
CAT BREEDS M F
Ragdoll Cat
Abyssinian Cat
Himalayan Cat
Persian Cat
Siamese Cat
Savannah Cat
Burmese Cat
Manx Cat
Sphynx Cat
Exotic Cat
Munchkin Cat Others, please specify: ____________
4.2 For those who answered no in question no.1, would you like to
buy a family pet dog/cat?
( ) Yes ( ) No
If yes, what specific dog and cat breed (pure) and gender do you
like to buy? Check your answer/s.
7. Are you willing to buy pet dog with Philippine Canine Club
Incorporated (PCCI) paper?
Note:
PCCI paper is like a birth certificate that lists down the date of
birth of the dog, its sire and dam, color and specific markings.
It shows the genetic lineage or ancestry (four generations in the case
of the PCCI) of each dog.
( ) Yes ( ) No
If yes, will you buy the following dog breeds with the given
prices below:
If no, will you buy the following dog breeds with the prices
below: