Chaland's Waitlist Form

Chaland's Waitlist Form

Complete this form only if you wish to be added to the waitlist. Completing this form indicates a commitment to purchasing a puppy from our breeding.
Name

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.
Please list your veterinarian's contact information:
Please provide 2 personal references who can attest to your ability to provide proper care, including quality food, exercise, heartworm preventative, veterinary care, training time, etc.
If you belong to a dog training club, breed club, etc please list them here:
Please check each box in agreement to the following:

You agree that you are committed to purchasing a puppy from Angela Chamberlain/Jeremy Chamberlain aka Chaland and would like to be added to the waitlist. You agree that upon submitting this form you will send the $250 waitlist fee via Paypal. This fee will be refunded in the event that you are not approved for the waitlist. This fee is NOT refundable in the event that you change your mind about purchasing a puppy from Chaland and/or wish to withdraw from the waitlist. The fee will be applied to the cost of your puppy (when one is available to you), so that you will need only pay the remaining balance of the puppy fee. Additionally: You agree that in the event that you are not approved to be added to the waitlist, after screening your references and such, that you will be refunded the $250 waitlist fee in the same manner that it was received (I.e. if sent in Paypal, it will be refunded via Paypal). You agree that in the event that you are approved to be added to the waitlist, after screening your references and such, but you choose to buy a puppy elsewhere or request to be removed from the waitlist, you forfeit the the waitlist fee to Chaland.
By typing your name below you agree that all information provided here is true and accurate and that you would like to be screened to be added to the waitlist for a Chaland puppy. You agree to the requirements above related to the waitlist fee.
Should be Empty: