Application

* Indicates required field

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Email *

If Other please specify: *

Preferred Color *

Red & White Sable & White Red Headed Tri Black Headed Tri

Gender Preference *

Male Female Either

Plans *

Companion Conformation Events Performance (OB/Rally/Agility) Breeding

Do you have any dogs now? *

Yes No

Where will the puppy be spending most of it's time *

If you've had dogs in the past what happened to them? *

FIrst Time Dog Owner *

Yes No

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