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First Name

Last Name

Email

Phone

Tell me about (your lifestyle and family ( if you have one),or anything else to make sure we match you with a puppy that fits your needs and dreams.

Number of children and ages? (if applicable)

Do you currently have pets? If so,tell me more about them.

What City and State do you live in?

Will you be the primary caretaker of the puppy? If not, who will be helping you?

What gender do you perfer (Male, Female, Any)? What color do you perfer?

Thank you for submitting!

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