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Valness Yorkies LLC
Valerie, Vanessa & Kathy Pittman
Owners/Operators
Washington County, Maryland
301-857-8688
ValnessYorkies@outlook.com
https://www.facebook.com/valnessyorkies/
You certify you are at least 18 years of age. If not, please have a parent or guardian fill in this Questionnaire. (When picking up pup person 18 years of age or older must be present to sign contract!)
Yes
Full name of person filling this form out if different than whom my pup/dog will reside with below:
If the person filling this form out (above) is different then the person that my pup/dog will be residing with (below), please give details of the situation.
Full Name:
Address (Street, City, State & Zip):
Phone Number:
Email Address:
How many in your household? What are their ages? Please make sure young children are supervised with pup!
Type and number of pets in your household:
What is the name of the pup you want to put your deposit toward? (if unknown, please put "unborn" or "undecided"):
Do you want a male or female?
Male
Female
1st Available
Undecided
By checking you certify you have read our Health Guarantee/Contract Page, Bringing Pup Home Page as well as our Payment Page!
Yes
How can I expect your deposit? (NOTE: Pups are not held until deposit is received. No pup is held without FULL payment after 8 weeks old, deposit placed or not).
Postal Money Order
Check
Cash In Person
Credit Card Over The Phone (fee does apply)
Credit Card In Person (fee does apply)
Paypal Online (fee does apply)
You are aware that deposits are non refundable? (See Payment Page of website for full deposit details).
Yes
You are aware balance due can be paid in cash at pick up but ALL other payment methods must be made 10 days prior to pick up. Regardless of payment date, if payment is not cleared pup does not leave my home.
Yes
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