Interested in a Puppy?  Please complete the following form and email it to us.
(Please Note I do not open attachments, please copy and paste the questionnaire in your email):
Thanks  

Name: 
Address:
City: Province/State:  
Zip:
Home Phone: () - Business Phone: () -


Have you ever owned a Bichon Frise or a Havanese? Yes No
If so:
When & What Breed: 
Sex: Male Female
Where purchased: Breeder Pet Store
Reason for purchase: Show dog Breeding Pet
Do you still have the dog? Yes No
If no, why not:


If you are thinking of purchasing a puppy, will it be for:

You and your family
A friend

How many people are in your family:

Adults: Children: 
Ages of children, if any: 
Have the children ever owned a pet? Yes No
If so, what kind: 
Where is the pet now (if gone, please explain):


Please explain, in your own words, what prompted you to think of owning a Bichon Frise or Havanese Puppy :

Would you consider spaying or neutering your puppy? Yes No
If no, why not:


Please provide references as to character and ability to provide a stable and loving home for the puppy:

Name of Reference 1:
Phone: () - Fax: () -
Name of Reference 2:
Phone: () - Fax: () -
Name of Reference 3:
Phone: () - Fax: () -

Please provide the name and phone number of your veterinarian:
Name of Veterinarian:
Phone: () - Fax: () -
Thank you for you time and patience.
Please note that we are unable to return long distance phone calls.   Most often we can be reached during the day time hours and weekends.                    Your understanding is appreciated.