Your Name*

Your Address*

Your City*

Your State*

Your Zipcode*

Your Phone number* || Please put dashes in your phone number!

Your Alternative Number || Please put dashes in your phone number!

Your Email*

How do you wish to be contacted?*
PhoneEmailEither

Desired range of size?*
Any Size50-7575-90

Desired color?*
Any Color?Dark GoldRedDark Red

Desired gender?*
MaleFemaleEither

Desired timeframe (select as many as you wish)?*
Any timeRight nowWithin 2 months2-4 months4-6 months6+ months

Describe your previous puppy experience:

What kind of pets do you have currently?

Describe the type of puppy you want:

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