Application

Name

First

Last

Email

Phone

address:

city, state, zip

How did you hear of us?

Your answers to the following questions will help us to match you with the perfect puppy for you.

Have you owned a dog before?

yes

no

Sex

male

female

no preference

Coat Type

smooth coat

plush coat

no preference

Type:

companion

show/breeding

working temperament

How many people resided in your household?

How many children? and what are their ages?

Tell us what you are looking for in a puppy:

Veterinarian References

Thank you for considering a JnL Pocono Shiloh puppy. Our hope is to establish a friendship with all of our puppy buyers for the life of their dogs and after.

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