Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

How would you like us to contact you?

Call

Text

Email

Will this be your first time owning a dog?

Yes

No

Will your new puppy be around children?

Yes

No

Do you have a Gender preference?

Male

Female

Do you have a Size preference?

Toy 7-10lbs

Miniature 10-18lbs

What color are you hoping for?

Black

White

Salt & Pepper

Parti

Tan/Brown

Would you like your puppy to be groomed or shaven before they go home?

Yes

No

Is shipping required? How do you plan to ship?

I will pick up my puppy in person

Airplane

Open to discussion