WWW.BUYPOODLES.COM

Please print this form and send it with your Deposit.

EMAIL OR CALL ME FIRST ABOUT AVAILABILTY ON OUR PUPPIES. E-mail: electriceyes@sbcglobal.net Phone: (815)  933-1876 for J. Shane I have been approved for a (check one) (   )Tiny Toy Poodle Puppy      (   )Teacup/Pocket Poodle Puppy   (   ) Teacup Yorkshire (Yorkie) (  ) Tiny Yorkshire (Yorkie) and    (   )  male  (   )  female  (   ) either          If color is very important, please choice: Color 1:______________________________ Color 2:______________________________

Please make payable to  J. Shane        I am sending a non-refundable min.deposit of $300.00 or more to hold (Name of puppy)________________________________ Amount $______________ Out of Mother's name) __________________________ Date _________________

I understand that a deposit is good faith money saying that I definitely want the puppy. The deposit holds my puppy, and guarantees that it cannot be purchased by anyone else.  I understand that all deposits are non refundable unless the puppy would become ill or deceased. All puppies are sold as quality pets, but with full registration papers unless noted.  Rest of the balance on the puppy must be paid in full within two (2) weeks of deposit or payment arrangments made with Buypoodles. Your name____________________________________________ Print_________________________________________________ Address______________________________________________ City,State,Zip_________________________________________ Email Address_________________________________________ Telephone____________________________________________