Name
*
First Name
Last Name
Complete Address (Street, City, State, Zip)
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Today's Date
*
What is a good time to call and talk about your puppy?
*
Gender Preference
*
Male
Female
N/A
Color Preference
*
White/Black
White/Brown (Red)
Tri
No Preference
Are you currently a breeder or plan to be in the future?
*
Do you have a fenced yard or other way to keep your dog safely contained? Please tell us a little about your home
*
Where do you plan to keep this dog at night, and when you're not at home and how many hours a day will your puppy be alone?
*
Do you have children in your home? What are their ages?
*
How did you find us?
Are you aware that Short Jack Russells are both high energy and lap dogs and they do require exercise as well as time for bonding?
*
I understand that there is a $250 NON-REFUNDABLE deposit to hold a puppy.
*
Thank you for taking the time to fill out our Puppy Application! If you have any questions, please feel to ask here!
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