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Cold Harbor Portuguese Water Dog's

First Name

Last Name

Street Address

City

Region/State/Province

Postal / Zip code

I have a fenced yard

Puppy Preference

Male

Female

Either

Coat Preference

Curly

Wavy

Either

Color Preference

No Preference

Must be black

Must be Black and White

Must be Brown

Must be Parti (Lots fo White)

Phone

Email

Number of Children in your home

List Children ages and sex

AGE

Relationship Status

Married

Single live alone

Single live with others

Describe your home and yard

Dog experience (Breed, age, Cause of death. Training)

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