FIRST NAME:
* This field cannot be blank *
LAST NAME:
City:
State:
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
PUPPY NUMBER:
All questions and offers on this form are only for the puppy number you enter.
Please fill out a separate form for each puppy you are inquiring about. * This field cannot be blank *
Breed:
Sex:
Dollar Amount: $:
Amount I would like to offer on puppy listed above.
Bank Transfer Option:
I am willing to do a bank transfer if needed.
Sorry, I cannot do a bank transfer if needed
Cash Option ( Local Customers Only ):
I can make cash payment if needed.
Sorry I cannot make cash payment
I am out of area and cannot pay with cash
I can make a cash or debit card payment if needed.
I can only pay with credit card if offer is accepted
I prefer to receive an answer via:
E-Mail or Call any numbers I have listed
E-Mail Only
Call only my Cell Phone
Call me at Home or Cell
If this pet is a surprise for a Birthday or gift.
Please select a contact option.
Home or Primary Phone:
* This field cannot be blank *
Cell Phone:
PRIMARY E-MAIL ADDRESS:
* This field cannot be blank *
Work EMail:
Other E-Mail Address:
Will you need pet shipping?:
Yes, I will need pet shipping
No, I will pick my puppy up in person
Select this option if the puppy is currently on hold.
Please Contact me if this puppy becomes available.
( * See additional information below * )
If I do not purchase this puppy I, would like to be added to the waiting list for a upcoming puppy. Please contact me and let me know how I can be added. ( Deposit Required to be added to our waiting list )
If the puppy you are inquiring about is on temporary hold, on hold for pick up, shipping or payment etc....
Please fill out a Puppy Purchase Application for this puppy.
If you feel confident that you would like to purchase this pet, if the hold is released.
Questions or Comments Here: