Xanadu of the Rockies
Puppy Deposit Questionnaire
Name
First Name
Last Name
E-mail
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Which hybrid or multigenerational breed?
Which litter; Dam and Sire?
Gender of pup you want:
Desired size; choose one: Standard, Mini, Super-Size-Me (we rarely have really big dogs):
Indicate whether you want a Guardian puppy (future XANADU breeding dog--2 litters for females, four for males), a Litter Pick pup, or a Pet Home Puppy. (Please write for information if you'd like to be considered for Guardianship.)
If you select a Litter Pick Female or a Litter Pick Male puppy, please note Litter Pick wishes. Examples of Litter Pick male and female characteristics YOU desire may be: "Low-shed & blue eyes; wolf-like-mask, & low-bark," or "Solid color, smooth-coated," or "Tri-color markings w/mask and brown eyes," or "Candidate for service training and great jogging partner," etc.:
Please note Blue or Brown Eyes, if there is an eye-color option:
If Low-to-No-Shed is required, please note:
IF you are paying the deposit for a puppy for someone other than yourself, please provide their name below.
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Puppy Deposit
$
400.00
Quantity
1
2
3
4
5
6
7
8
9
10
Total
$
0.00
Payment Methods
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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the form.
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