If you are interested in a puppy from Aegys, please complete this form and return it to me with a deposit of $200.  Deposits will be held and puppy orders filled in the order of date received.  Should the type of puppy you request not be available, your deposit will be returned, or held for the next litter, whichever you prefer.  When this form is received, I will review it, sign it, and return a copy to you.  Please also complete the Questionnaire and send it with the Reservation Form.

 

Name: __________________________________________________

Address: ________________________________________________

                 ________________________________________________

Email: __________________________________________________

Phone: __________________________________________________

Fax: ___________________________________________________

Signature: _______________________________________________

Signature of breeder: ________________________________________

Date of receipt: ____________________________________________