A Friend for Life
Your name*
Your Address*
Your City*
Your State*
Your Zipcode*
Your Phone number*
Your Email*
How do you wish to be contacted?*
phoneemaileither
Desired range of size?*
Any Size15-2525-35
First color choice?*
Any Color?Dark Apricot to Red (common)Dark Apricot (common)Cream (less common)
Second color choice?
Desired gender?*
malefemaleeither
Desired timeframe (select as many as you like)?*
Any timeRight nowWithin 2 months2-4 months4-6 months6+ months
Do you have allergies to dogs?*
YesNoUnsure
Describe your allergies:
Describe your previous puppy experience:
What kind of pets do you have currently?
Describe the type of puppy you want:
Once you have completed the application, click send
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