Application Form

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Use tab to navigate through the menu items.

Please submit an Application and tell me about yourself.

I will contact you as soon as possible. For MORE INFORMATION on process click the button below.

Application Process

Application Form

Please take a moment to fill out the form.

First Name

Last Name

Email

Phone

Address

Number of children in home and ages

Do you currently have any pets? *

YES

NO

Have you owned a dog before? *

YES

NO

Have you ever surrendered a pet before? *

YES

NO

If yes, please explain

Have you researched owning a Shih Tzu dog? *

YES

NO

Have you owned a Shih Tzu before? *

YES

NO

Do you want black pigment or liver? *

BLACK

LIVER

NOT SURE

Do you need permission to have a dog? *

YES

NO

If YES, indicate preference

Do you have a preferene on color or size? *

YES

NO

Do you plan to breed this dog? *

YES

NO

Tell us about you, your family, lifestyle and anthing else you'd like to share?

What type of home would your new dog live in with you? *

HOUSE

APARTMENT

OTHER

Will you be the primary caretake of your dog? *

YES

NO

If no, who will be?

Photo of you or your family (optional)

Upload File

Upload supported file (Max 15MB)

Preference Information

Gender preference *

FEMALE

MALE

NO PREFERENCE

Color preference (If none, enter 'no preference')

Size preference (if non enter 'no preference)

Transfer Information

Which pick-up or drop-off options are you interested in?

In-person pick-up

Courier

Thanks for submitting!

imperialshihtzumomma@gmail.com

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