Please fill out the form below with your answers and then hit the submit button at the bottom. Your application will be sent automatically to my email. Thank You

Buyer Name *
Your Email Address *
Street Address *
City, State, Zip Code *
Home Phone *
Work/Cell Phone *
Name of SureFire litter you are interested in. *
How or where did you learn about this litter? *
Why do you want a Golden Retriever? *
Main Use: (Pet, Hunting, Obedience, Agility, etc.)
Sex Preference: Female, Male, Either? *
Color Preference: Light, Dark, Gold, Red, Any? *
How many and ages of children in your home? *
Do you have other pets? What kind? *
Will you spay/neuter your pup? *
Will your dog be mostly indoors or outdoors? *
Do you have a fenced yard? *
Will pup need to be shipped or can you pick it up? *
Tell me a little about yourself.
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