GOLDEN PUPS KENNEL                  #_____


Dam:______________ Sire:______________ Puppies date of birth:__________

A $400.00 deposit is required to hold a puppy.  Deposits are non-refundable.

(Name) ___________________________ paid a $400.00 deposit.

Plus (an extra) $_______________ with a remaining balance of $________.00

Paid by:    Check #_____  /  Cash 


I am reserving a (gender) _______________  and will do my pick at 7 weeks of age. 

I will pick the puppy up within the first week of the ready date.

Ready date for this puppy is: ______________


The full remaining balance is required prior to pick up.


Purchaser (owners) name: ________________________________________

Address: _______________________________________________________

City___________________________ State: ___________ Zip: _____________

E-mail: _________________________________ Phone: __________________




Date:_____ New Owner: ___________________ _ Breeder: ____________________



Where did you hear about us? ____________________________________________

If you refer us to someone and they purchase a puppy. You will receive a $50 visa card. Or If someone else referred you to us that has purchased a puppy from us, tell us who and they will receive a $50 visa card.


Purchaser picked the _________________ (color) ribbon puppy.