KPPK Questionnaire Form for a Pembroke Welsh Corgi

Owner Diann Kocher C: 417-396-7352

Required *

Please Fill Out In ENGLISH Format Only, Any Other Language Formats Will Be REJECTED. If it does not apply to you please put a "N/A", nothing is allowed to be left as empty/blank. If not 100% completely filled out, this questionnaire will be REJECTED.

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First & Last)
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youremail@email.com
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** DO NOT shave your corgis in ANY weather. Do Not Clip, Shave, or Cut the coat unless it's a medical reason by your vet, Not Your Groomer. They are not dogs to be SHAVED. **

HRS/MIN/SEC

This is letting you know this is a Recommended Spayed & Neutered Contract at new Owner's expense only never the breeders.

** For locking in Prices please see "Waiting List Terms And Conditions" Page.

1st Preference

2nd Preference

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*Please List Three (3) References:

Name, Phone #, & Relationship
Name, Phone #, & Relationship
Name, Phone #, & Relationship

To Join is $100.00 Plus a $5.00 to process the payment, it will be deducted off the final payment of the puppy.

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** I do not have a set price, prices are determined by market and shipping. Prices are not stated on my KPPK Website or my KPPK Facebook Page. It's all done thru PM and again no prices is quoted unless puppies are already born. All prices are subject to change whether the transportation goes up or the market goes up, it's at the breeder's discretion.

Electronic Signature & Agreement:

First, M, Last.