Puppy Application Form

Puppy Application

The information contained in this application is used only for the purpose of placing a puppy and will not be used elsewhere. A $500 deposit is required to be on the list for a golden retriever puppy. $500 will be deducted off the total price.
Full Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
E-mail
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
What Gender are you looking for?
Would you be interested in puppy training? Kennel, leash walking, basic commands?
Would you like to have the puppy delivered?
Do you agree to contact Alexis Styers in the event you cannot keep your puppy?
Do you want a puppy with confirmation lines? High drive? Medium drive? Low drive? Hunt drive?
By sending this electronically, I acknowledge that I have completely read this questionnaire and comprehend it fully.

I understand that applying does not ensure approval
Date

MonthDayYear
Your name
The $ 500 deposit is non-refundable but can be transferred to another litter.
Should be Empty: