Hutsok Maltese and Biewer's

First Name:		Last Name:
Address:

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Home Phone:		Work Phone:
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What type of delivery are you interested in? Ship airmail Pick-up

What is the name of your closest airport?

Preferred Payment Option: Deposit Pay in full

What is the sex of the puppy you are interested in? M F

At what age do you wish to get the puppy?

How many pets do you currenty have?

Do you have a fenced yard or suitable pen?

Where will the puppy be kept?

Have you ever taken a dog to a pound or shelter?

How did you hear about us/referred by?

Have you read/agree to the terms of the sales agreement? Y N

Please tell us something about yourself and why you want a puppy?

Let us know if you have any other comments or questions.

Breeder of Maltese and Biewer Yorkies