Adoption Application

About You

Full Name*

Email Address*

City, State*

Phone Number*

What gender do you prefer?*

What registry would you like? *

AKC (American Kennel Club)

AHMPC (American Harlequin Miniature Club)

Either

Are you a breeder?*

Yes

No

If you are a breeder, tell me about your program.*

Where are dogs kept? How many do you have? What is your setup for breeding dogs/raising puppies? If you are not a breeder enter N/A.

Do you have a fenced yard?*

Yes

No

Tell us about the people in your household

How did you hear about us?