KPPK Questionnaire Form

Required *

Please Fill Out In ENGLISH Format Only, Any Other Language Formats Will Be REJECTED.

(Pick One)
First & Last)
(###)###-####
(###)###-####
(Pick One)
(Pick One)
youremail@email.com
(Pick One)

** Please DO NOT shave your corgis in any weather, they are not dogs to be SHAVED. **

HRS/MIN/SEC

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

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

(Pick One)
(Pick One)

*Please List Three (3) References:

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

Paid Waiting List, there is a Nonrefundable $100.00 Fee which will be deducted from the price of the puppy.

(Pick One)

** For prices of the puppies please either email me thru this website or PM thru our KPPK Facebook page, please keep in mind prices for puppies and travel transportation is NEVER Set in stone and prices can change at any given time.

Electronic Signature & Agreement:

First, M, Last.