First Name: *
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Last Name: *
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Home Address : *
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CIty: *
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State:
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Zip Code: *
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Evening Phone: *
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Email: *
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Are you looking for a puppy or adult?: *
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Do you have a preference for male or female?: *
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Do you have children, what ages?: *
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Are you willing to spay/neuter your puppy: *
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Does everyone work and/or how many hours at a time will your puppy be left alone?:
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Tell us about previous/current pets you have owned and what happened to them:
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Please describe what you are looking for in a dog: *
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