Tracy Joubert

                                                                         1165 Jo-Mil Loop

                                                                         Eunice, LA 70535

                            Puppy Deposit

Name_______________________________________

Address__________________________________

$100 deposit

Phone Number____________________     Cell Number ______________________

Email Address:________________________________

Puppy Color: 1st choice_____________________________    

                        2nd choice____________________________

Male_____    Female_____   Either________

Shipped:  Yes_____    No_____         Name of Airports: 1st choice:____________________________________________ 

                                                                                                 2nd choice____________________________________________

Money Orders/Cashier's Check or Western Union ONLY !!!