What is your email address?

What is your phone number?

Which breed are you interested in?

Are your interested in show or pet quality?

Have you ever bred a litter of puppies yourself?

What is your physical address?

Please give two references (name,address & phone)

Name & phone number of your veterinarian?

How many and what types of pets currently live in the home?

Do your prefer to be contacted via phone or email?

Thank you for filling out our questionnaire!