Congratulations on your decision to purchase a Quad City Multigeneration Australian Labradoodle. We are confident you will be thrilled with your new dog.

Please complete the application and return it with a $350 non-refundable deposit. Your deposit will be credited to the purchase of your new puppy. Your completion of this application will help us in providing you with the best labradoodle for you and your family.

Completed reservations, with deposit, are accepted in order of receipt. Payment may be made by check payable to Quad City Labradoodles.

Please print legibly!

Name: ________________________________

Street Address: ________________________

City: _________________ State _____ Zip___

Home Phone: _________________________

Day Phone: __________________________

Cell Phone: __________________________

E-Mail: _______________________________

Fax: _________________________

Pet ($350) __________ Breeding ($500)______

Date you can take your new puppy: _________

Please list your preferences below: Circle one or more where appropriate

1. Does anyone in your family suffer from asthma or allergies related to dogs? Y N

2. What gender do you prefer? M F Flexible

3. What coat type do you prefer? Fleece/Curly Fleece/Wavy Wool/Fleece

4. Does your family have: Very young children? ______ Elderly?_______ Physically Impaired? ________

5. Is your yard fenced? _________________

6. Is your lifestyle: Sedentary Somewhat Active Active

7. Do you have other pets? Please list_________________________________

8. Where will your puppy sleep? _____________________________________

9. Desired Puppy Nature: Active Mellow

10. Anything else you would like us to know?

________________________________________

All Quad City Labradoodle puppies come with a 2 yr. guarantee against genetic diseases. They receive age appropriate vaccinations and deworming. We desex all pet puppies and microchip every puppy. We are available to help you throughout your puppy's life. Quad City Labradoodles reserves the right of first pick for breeding purposes.

Puppy Price: $2,500.00 (price does not include shipping)

Signature: _____________________ Date: ________

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Date Delivered _______________ Puppy name ___________