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Name:
E-Mail Address:
Q1: What kind of puppy are you looking for? Male Female Don't know Doesn't matter
Q2: What housing features do you have? (Select all that Apply): Do you have a Backyard? If you have a backyard, check here if fenced Is the house puppy safe, check if yes
Q3: How soon would you like to have the puppy? Right now1 Month2 Months In the next 6 months Later this year
Q4: Do you consider yourself an experienced dog owner? Strongly Agree Agree Neither Agree Nor Disagree Disagree Strongly Disagree
Questions or comments you have (NOTE: This field is REQUIRED):
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