Name *

Email *

Street Address *

City or Town *

State or Province *

Zip or Postal Code *

Phone *

What age dog are you interested in obtaining? *
PuppyYoung AdultRetiree

What sex? *
MaleFemaleEither

Have you ever owned a Maltese? If yes, please tell me about your prior dog(s). If no, please tell me why you want a Maltese. *

What activities would you like you and your Maltese be involved in? *
CompanionShowsObedience or agilityBreedingTherapyOther

If "Other" above, please tell us more about the plans you have for your Maltese.

Please tell us a little about yourself (occupation, family, experience with dogs generally and Maltese specifically, other pets, children) *

Where will the dog stay during the day? Where during the night? *

Tell us about where you live. Are you in a city or a more rural area? Home or apartment? *

Do you have a fenced in yard? *
YesNoI don't have a yard

Please provide the name, city and phone number of your vet. *

Please provide the name, city and phone number of your groomer, if you have one.

How much do you want your new dog to weigh as an adult? *

Have you ever bred a litter of puppies? *
YesNo

Have you ever taken a dog to a rescue or shelter, or given away or sold one you owned? If yes, please state the circumstances. *

What is(are) the most important characteristic(s) you are looking for in a new puppy/dog? *

Please let us know any additional information you would like us to consider.

*required

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