American Hairless Terrier
 Owner Questionnaire

        Please provide the following contact information:

First Name
Last Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Home Phone
E-mail
URL

        May we share your data with other approved AHTA members?

        Yes No

        Do you own any coated dogs?

        Yes No

        How many AHT's do you own?

        0 1 2 3 4 5+

Are you willing to assist other prospective AHT owners by allowing them to perform an "allergy test" with one or more of your dogs?

Yes No

My AHT(s) are (choose all that apply):

pets              

show dogs         

breeding dogs     

all of the above

Optional - Please list your pet's name(s), sex, color, and date of birth.