Seeking Shalom Acres
© Dr. Meg Howe, EliteBreederFormula.com
New Owner Information
Please complete the following information.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Puppy Information
Please complete the following information.
Puppy's Name:
*
Puppy's Date Of Birth:
*
-
Month
-
Day
Year
Date
Puppy's Sex:
*
Male
Female
Pick-Up Information
Please complete the following information.
Pick-Up Date:
*
-
Month
-
Day
Year
Date
Pick-Up Time:
*
Hour Minutes
AM
PM
AM/PM Option
Pick-Up Location:
*
Radford I-81 Southbound Rest Area
Wytheville Lowes Parking Lot
Lambsburg Truck Stop
Other
Make / Model / Color Of Pick-Up Vehicle:
*
Payment Due At Pick-Up
Please be sure to have the balance of your payment with you at puppy pick-up. Cash is preferred but Zelle and PayPal are also options. If you opt to pay using PayPal, please add 3.5% to cover PayPal fees.
Payment Method
*
Cash
Zelle: Send to SeekingShalomAcres@gmail.com
PayPal (add 3.5% PayPal fees): http://paypal.me/SeekingShalomAcres
Balance Due At Pick-Up:
*
Other Information
Please complete the following information.
Comments:
*
Terms & Conditions
Pick-Up Agreement
*
I, the buyer, agree to meet the seller at the time, date, & location above. If I'm unable to meet for some reason, I will contact the buyer ASAP to make other arrangements. If I'm unable to meet within a week of the date above, the seller has the right to consider selling the puppy to another buyer.
Signature & Date Below
*
I understand that by entering my name and today's date below, it shall count as my digital signature.
Full Name / Digital Signature
*
This counts as your digital signature.
Today's Date
*
This shall count as the date of your digital signature.
Submit
Should be Empty: