NAME:
* *
First Name, Middle Name, Last Name
( Enter full name of person making payment for pet shipping )
STREET ADDRESS:
CITY:
STATE:
AK - Alaska
AL - Alabama
AR - Arkansas
AZ - Arizona
CA - California
CO - Colorado
CT - Connecticut
DC - Washington DC
DE - Delaware
FL - Florida
GA - Georgia
HI - Hawaii
IA - Iowa
ID - Idaho
IL - Illinois
IN - Indiana
KS - Kansas
KY - Kentucky
LA - Louisiana
MA - Massachusetts
MD - Maryland
ME - Maine
MI - Michigan
MN - Minnesota
MO - Missouri
MS - Mississippi
MT - Montana
NC - North Carolina
ND - North Dakota
NE - Nebraska
NH - New Hampshire
NJ - New Jersey
NM - New Mexico
NV - Nevada
NY - New York
OH - Ohio
OK - Oklahoma
OR - Oregon
PA - Pennsylvania
RI - Rhode Island
SC - South Carolina
SD - South Dakota
TN - Tennessee
TX - Texas
UT - Utah
VA - Virginia
VT - Vermont
WA - Washington
WI - Wisconsin
WV - West Virginia
WY - Wyoming
Not USA
Country
List Country if you are not in the United States
Occupation
Photo templates, blankets, toys & bows for your occupation or profession will be offered if available.
ZIP CODE:
PRIMARY E-MAIL ADDRESS:
* *
This can be Home or Work
Work E-Mail Address:
Other E-Mail Address:
PRIMARY PHONE NUMBER:
* *
This field cannot be blank
Cell Phone Number:
Work Phone Number:
Are you a previous customer?:
No I am not a previous Customer
Yes, I am a previous customer
Puppies Received:
*
This will be my First Pet from TeacupAndToyPets
This will be my 2 nd Pet from TeacupAndToyPets
This will be my 3 rd Pet from TeacupAndToyPets
This will be my 4 th Pet from TeacupAndToyPets
This will be my 5 th Pet from TeacupAndToyPets
This will be my 6 th Pet from TeacupAndToyPets
*
Amount of Puppies Purchased from TeacupAndToyPets
Pager or Beeper:
How did you hear about us?:
Referred by:
Information about the Puppy I would like to purchase
PUPPY NUMBER #
* *
Please enter all Letters & Numbers on puppy picture if possible
BREED:
Short or Smooth Coat Chihuahua
Long or Medium Coat Chihuahua
Malti Poo
Maltese
Jack Russell Terrier Chihuahua Mix
Chihuahua Terrier Mix
Toy Malti Poo
Yorkie
Morkie
Pomeranian
Maltese Shih Tzu Mix
Havanese
Shih Tzu
Miniature Schnauzer
Peekinginse
Breed not listed on web site
Not sure of breed
Chi-Weenie Chihuahua Dachshund Mix
Peek A Poo
Misc. Mixed Breed
Daisey
Breed not listed
SEX:
Size:
Color of Puppy :
Puppy Pick Up & Shipping Preferences
I will be picking my puppy up in person in Dallas Texas
First Airport Choice:
Enter airport name and airport code if known.
Second Airport Choice:
Enter airport name and airport code if known.
Third Airport Choice:
Enter airport name and airport code if known.
I am requesting that my puppy be shipped @ Continental Airlines if possible.
( Select this option only if your pet is not a Toy and you do not want to pay for premium shipping )
I understand that, Premium Shipping is required on Tiny Teacup, Teacup, Tiny Toy & Select Puppies:
I am ready to receive my puppy on or after this date:
Health Certificate needed for Pet Shipping:
*
Add $129.00 for Health Certificate to ship my puppy
I do not need a Health Certificate will pick puppy up in person
*
A Health Certificate will be needed for your puppy if it will be shipped by airplane and maybe needed if you take your pet home via airlines. Check with your airlines for their requirements.
Cozy Sweater for my puppy
NO, I do not want a sweater at this time
Please send a RED Sweater ( $12.99 )
Please send a PINK Sweater ( $12.99 )
Please send a BLUE Sweater ( $12.99 )
Pet Crate Choice:
Standard Crate for shipping pet. ( $25.00 )
Deluxe Crate Upgrade ( Blue or Green Add $30.00 to total )
Pink Deluxe Crate Upgrade ( $35.00 )
See photos below application.
Package of Colorful Bows for my puppy's hair ( Add $3.00 )
Please paint my puppy's toe nails if possible ( Free / No Charge )
Please include a thick colorful blanket for my puppy to snuggle in during shipping ( Add $12.95 to total )
Blanket Style / Color Choice:
Purple
Yellow
Orange & White
Blue
Pink
Green
Colorful Blanket for Female Puppy
Colorful Blanket for Male Puppy
Sports Blanket for Male Puppy
Click open picture of blanket below to see color choices.
PUPPY STARTER PACKAGE
Free Puppy Starter Package ( $10.00 )
I, want to purchase the Deluxe Puppy Starter Package ( $75.00 )
Please send the Premium Puppy Starter Package ( $250.00 )
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* Puppy Starter Package Choice *
Click open picture below to see starter package choices.
Add Subtotal Amount Here $
Add all items that you are requesting to your subtotal
.
Waiting List Deposit Amount
Subtract this amount from your subtotal
Referral Credits
Subtract the amount of your referral credits on this line
Preferred Payment Option:
Credit Card
Cash
Personal Check by mail
Business Check by mail
Bank Transfer to Bank of America
( Credit Card Number not required at this time )
Total Amount Due:
Total after you subtract your deposit, coupons and credits.
Credit Cards we accept for Puppy Purchase
Credit Card Choice:
VISA
Master Card
Visa Debit ( Only in person )
American Express ( Purchase must be under $2,500.00 )
Discover
Home Fax Number:
The person that is purchasing this pet must match the name on credit card that will be used to purchase pet.
Work Fax Number:
Name of Company we will be sending fax to:
Total Payment Amount:
Add supplies & shipping options if needed.
Then subtract your discounts, credits and referral credits.
Enter Total Payment Amount on this line.
When you click submit you agree to accept this puppy according to the agreement which includes a 3 day the health guarantee administered by Teacup And Toy Pets.
For more information on care & training your puppy visit the information section of our web site. I, also understand all free puppies are as is. However I will be offered a 3 day health guarantee for my puppy and it will become valid only when I return it by certified mail and fax to: Teacup And Toy Pets. I understand that I must read, sign and return a copy of my health guarantee within 3 days of puppy purchase to be valid or signed by purchaser at time of purchase if you will be picking your puppy up in person.
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