Wind Dancer Information Submission

Dear Dog Lover: Fill out Wind Dancer's Information Submission Form

I created this form as the best way to collect information on my potential puppy parents. In this way I can save this information directly to a database for future reference and mailings (it sure beats pieces of scrap paper). Most of the fields are not required but I would appreciate as much information as possible.

Thanks for your interest in Wind Dancer PONs!

Best regards, Nancy

First Name
Last Name
First Name 2
Last Name 2
Address
Address
City
State	AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA DC WV WI WY Zip
Day Phone
Evening Phone
Fax
Email
Would you prefer a: Male Female   N/A
Do you prefer a: Show/Breeding Quality   Pet   N/A
Pet History
Children & Ages
Grandchildren & Ages
Your residence  Apt.  Townhouse House Other
Do you have a fenced yard?  Yes   No
How many live at this residence?
Have you ever seen a PON in person  Yes   No
Do the adults in the house work full time Yes   No
Hours per day the adults are away from home
Comments