GOLDEN PUPS KENNEL
Dam: _________________ Sire: __________________
Puppies date of birth: _________________
I picked a (gender) _______________ with a (color) _______________ ribbon.
(Name) _______________________________ Paid $ __________.00 by
Check #______________ / Cash
Purchaser (owners) name: ________________________________________
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.