Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

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Color Preference (check all that apply) *

White

Golden

Caramel

Brown

Black

Any

Please check all size dogs that are acceptable *

Medium

Standard

I understand and accept the process for placement and adoption as well as the health guarantee of a SHAL. I understand the long term investment of time and money required to raise a puppy. I understand the SHAL reserves the right to decline an application based on our assessment of the prospective home. *

I agree

I do not agree