1. What is your Name? 2. Phone Number? 3. e-mail Address? 1. What are you looking for in a Manchester Terrier? 2. Have you ever owned a Manchester Terrier in the past? Yes No 3. Do you plan on showing or working the dog? Showing the dog Working the dog 4. Do you own your own home? Yes No 5. Please describe the property in which you live. 6. Do you have other dogs in the house? If so what breed? What sex? 7. Do you have children? If so what ages? None 1-5 years 5-10 years 10-15 years 15-20 years 20-25 years 8. Tell us a little about your life style. 9. Will the dog have a fenced in yard? Yes No 10. What activities will you be interested in with the dog? 11. What kinds of experience do you have with dogs? 12. Would you like a male or a female? Male Female 13 Show quality Pet quality