Name    

Address 

City         State  Zip

Contact Number

E-mail Contact

Will you need your companion shipped?  Please Select Yes No Not Sure

Apartment   or  House     Fenced Yard or Park Close

Where will your companion live?  Please Select One Indoor Pet Outdoor Pet Both

Sexual Preference: Doesn't Matter Male Female

Color Preference: Does Not Matter / Not Sure Dark / Red Golden / Blonde Light / White

Intentions for companion? Please Select Pet Show

Do you have children? Yes No

Other Pets / Past Pets - Please List

Why do you think a golden retriever is right for you?

Do you have any questions for us?