Hi-Mark Puppy Inquiry

                                       Name:

                            Home phone:

                                       Email:

                                  Address:

                  Personal reference:

                  Reference phone #:

                    Type of residence:

Where will dog be kept most of the time:

Members of household and ages:

                             Current pets:

                    Current veterinarian:


Veterinary phone #:

What are your plans for this dog?
Pet, Guard, Obedience, Conformation
showing, etc...Please explain:

        Do prefer male or female?

Are you willing to spay or neuter?

          Will you allow home visit?

May we forward this information to other
breeders?

Please give any further comments to
assist us in placing a puppy with you:

HI-MARK PUPPY INQUIRY
Form must be completely filled out for consideration.