Roberta's Pure Bred Pets

Yorkies	Himalayans

Thank you for your interest in purchasing a pet.

Application for Purchase:

----- Contact Information ---------------------------------------------------------------------------------------------------------------

First Name

Last Name

Address

City

State

Zip

Home Phone Work Phone Cell Phone

Occupation

----- References ----------------------------------------------------------------------------------------------------------------------------

Veterinarian Name

Phone Number

Reference 1 Name

Phone Number

Reference 2 Name

Phone Number

Reference 3 Name

Phone Number

Which airport would you like the pet shipped to?

Do you have any other pets living in the home? If yes, what kinds?

Do you have children living at home? If yes, what are their ages?

Do you have a gender preference for your new pet?

Are you interested in being placed on a list for a retired breeder?
Yes No

Which kitten pictured on our website is the puppy you would like to own?

----- Adoption Responsibilities --------------------------------------------------------------------------------------------------------

Roberta's Pure Bred Pets will guarantee the health of the puppy upon arrival and will insure that it has been vet inspected both before shipment and will request the person adopting to also have the puppy vet checked again upon arrival to confirm the health of the puppy. Roberta's Pure Bred Pets will only ship quality healthy puppies as has been verified by a veterinarian with a health certificate.
Have read and agree

Are you willing to give it the necessary immunizations and grooming and medications as needed throughout the life of this dog?
Yes No

Do you have the financial resources to give the puppy or dog any necessary medical care?
Yes No

Submitting this application will pre-qualify and add you to our e-mail waiting list. If the puppy or dog is available now, we will send you an adoption agreement and arrangements will be made to send the puppy or dog to you.

Payment Info
I accept Paypal or personal check for payment. If you are interested in purchasing a pet and have been approved for a home I will send you a payment form to your email or fax. I will not hold any puppy without a deposit. The deposit is $300 and due on the day that customer has decided to purchase the pet. All Deposits are NON-REFUNDABLE! If you have paid for your puppy in full and request to cancel the sale then Roberta's Purebred Pets will send you a credit minus the deposit of $300.

Shipping Info

I can ship your new puppy to the nearest International Airport weather permitting. The shipping cost is approximately $300 which includes crate, health certificate, small packet of food, travel fee and pet's favorite toy. All Shipping costs are NON-REFUNDABLE after the pet has been shipped to customer.