Puppy Buyer Application
Personal 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
Gender
Please Select
Female
Male
Rather not say
Do you live in house, mobile home, apartment, townhome or duplex ?
Yes
No
Do you have children?
Yes
No
Have you ever owned a dog or been raised with dogs?
Yes
No
Do you presently have pets in your home?
Yes
No
What dog gender do you prefer?
Female
Male
What breed are you looking for?
Yorkie
Morkie
Parti Yorkie
Shih Tzu
Other
If other breed please specify:
Do you have a fence yard?
Yes
No
How will you get puppy?
Pick up in person
Ground Delivered (extra fee apply)
Airplane Nanny (extra fee apply)
Please describe anything else that may help us with selecting the right puppy for you.
How did you hear about us?
Paypal Secure payment
*
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( X )
USD
$200 Deposit to hold your puppy.
Submit
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