1. Date:

2. Name:

3. Address:

4. City:

5. State:

6. Zip Code:

7. Phone Number: And Best Time To Call 

8. E-Mail Address:

9. Gender Of Puppy you want? Choose One Male Female Not Sure

10. Is every one in your home ready for a new puppy? Please Choose Yes No  

11. Do you Own or Rent your home:? Please Choose One Rent Own

12. If you Rent do you have permission from your landlord to get a puppy?: Please Choose One Yes No not yet No

13. Do You realize your baby will be VERY PRE-SPOILT? Please Choose One Yes No

14. I Knowledge that Shichon-pups.com places/sales ONLY companion pets. Yes

15. Do You Want A Baby That Is Listed On The Site Now ? Choose One Yes No Undecided

16. If So What Baby:

17. Have you read our health warrantee? Choose One Yes No

18. Do You Already Have A Vet? Choose One Still Looking Yes No

19. Your Vets Name & Number:

20. Who Will Take Primary Care Of The Puppy?:

21. Do You Have A Fenced Yard? Yard But No Fence Yes No

22. Do You Have Other Pets ? Choose One NA Yes No

23. What Kind? Choose One NA Dogs Cats Cats/Dogs Other

24. How Many? 0 1-3 4-6 6+

25. If you have other dogs what breed are they?:

26. Do You Have Kids? Choose One NA Yes No

27. How Old Are They? N/A 1-5 5-10 10+

28. How many kids do you have? N/A 1 2 3 4 5 or more

29. How Soon Do You Want Your New Baby? Undecided 1-2 weeks 2-4 weeks 4-6 weeks 6-8 weeks 8-12 weeks

30. Do You Want To Pick Up Your Baby Or Have Her/Him Shipped? Undecided Pick Up Plane

31. What Airport Is Closes To You?:

32. Please Tell Us Why You Would Like a Puppy & List Any Questions Or Comments You Have.

 

33. If we don't have the baby you are looking for at this time do you want to be added to our waiting list for when we have a litter? Yes