1. Date:

2. Name:

3. Address:

4. City:

5. State:

6. Zip Code:

 We must have a phone number to contact you. We taking placing our babies very seriously.

 NO Baby is placed with out personally talking to you. If you submit this form with out a number it will be deleted Sorry.

7. Phone Number: And Best Time To Call 

8. E-Mail Address:

9. Gender Preference? Choose One Male Female Not Sure

10. Is every one in your home ready for a new puppy? Please Choose Yes No  

11. Do you Own or Rent your home:? Please Choose One Rent Own

12. If you Rent do you have permission from your landlord to get a puppy?: Please Choose One Yes No not yet No

13. Do You realize your baby will be VERY PRE-SPOILT? Please Choose One Yes No

14. I Knowledge that Shorkie world places/sales ONLY companion pets. Yes

15. Do You Want A Baby That Is Listed On The Site Now ? Choose One Yes No Undecided

16. If So What Baby:

17. Have you read our health warrantee? Choose One Yes No

18. Do You Already Have A Vet? Choose One Yes No

19. Your Vets Name & Number:

20. Who Will Take Primary Care Of The Puppy?:

21. Do You Have A Fenced Yard? Yes No Yard But No Fence

22. Do You Have Other Pets ? Choose One NA Yes No

23. What Kind? Choose One NA Dogs Cats Cats/Dogs Other

24. How Many? 0 1-3 4-6 6+

25. If you have other dogs what breed are they?:

26. Do You Have Kids? Choose One NA Yes No

27. How Old Are They? N/A 1-5 5-10 10+

28. Price Range You Want To Spend? Undecided $900-$1100 $1101-$1500 $1501-$2000 $2000.00 and Above

29. How Soon Do You Want Your New Baby? Undecided 1-2 weeks 2-4 weeks 4-6 weeks 6-8 weeks 8-12 weeks

30. Do You Want To Pick Up Your Baby Or Have Her/Him Shipped? Undecided Pick Up Plane

31. What Airport Is Closes To You?:

32. Please Tell Us Why You Would Like a Puppy & List Any Questions Or Comments You Have.

*Credit Card NO CHARGE BACK POLICY*

I the person on this letter have paid for a Puppy using my Credit Card I agree to fore go ANY charge back for ANY reason under their NO REFUND policy. I understand any problems will be dealt with outside of a charge back credit directly with A buddy for you (DBA) Shorkie world. I Understand I will NOT be credited back on my Credit Card account for any reason if I cancel the sale, or are dissatisfied with purchase. I will get refund any money charged by check when proof of refund is deemed necessary. Buyer's acceptance of any animals agrees that this transaction was consummated within the state of Missouri and consents to the application of all Missouri Laws and to the jurisdiction of Missouri Courts. Should a dispute arise out of this transaction. Buyer further agrees that should he default in any obligation of this agreement, he shall be responsible for all attorney fees and court costs involved in the prosecution of this action. Acceptance constitutes An agreement to pay the above listed price and totals, with in agreed terms.

33. If I pay for my baby with a credit card I agree to the "CREDIT CARD NO CHARGE BACK" policy Yes