First & Last Name: Required
Email Address: Required
Telephone Number with area code; Cellular and/or land line: Required
What state and country do you reside in? AL,ALABAMA/USA AZ,ARIZONA/USA AR,ARKANSAS/USA CA,CALIFORNIA/USA CO,COLORADO/USA CT,CONNECTICUT/USA DE,DELAWARE/USA FL,FLORIDA/USA GA,GEORGIA/USA ID,IDAHO/USA IL,ILLINOIS/USA IN,INDIANA/USA IA,IOWA/USA KS,KANSAS/USA KY,KENTUCKY/USA LA,LOUISIANA/USA ME,MAINE/USA MD,MARYLAND/USA MA,MASSACHUSETTS/USA MI,MICHIGAN/USA MN,MINNESOTA/USA MS,MISSISSIPPI/USA MO,MISSOURI/USA MT,MONTANA/USA NE,NEBRASKA/USA NV,NEVADA/USA NH,NEW HAMPSHIRE/USA NJ,NEW JERSEY/USA NM,NEW MEXICO/USA NY,NEW YORK/USA NC,NORTH CAROLINA/USA ND,NORTH DAKOTA/USA OH,OHIO/USA OK,OKLAHOMA/USA OR,OREGON/USA PA,PENNSYLVANIA/USA RI,RHODE ISLAND/USA SC,SOUTH CAROLINA/USA SD,SOUTH DAKOTA/USA TN,TENNESSEE/USA TX,TEXAS/USA UT,UTAH/USA VT,VERMONT/USA VA,VIRGINIA/USA WA,WASHINGTON/USA DC,WASHINGTON D.C./USA WV,WEST VIRGINIA/USA WI,WISCONSIN/USA WY,WYOMING/USA Other
Will you sign a spay/neuter contract? Required YES NO
Do you have a preference to a male or female puppy? It does not matter. Male Female
If you have a preference for a specific litter, please select one now. A puppy in a current litter. A puppy in one of this year's litters. A puppy in a future litter.
What qualities are you looking for in a puppy?
Will you consider crate training your pup? YES NO
Do you have a fenced yard? YES NO If No, please tell us your plans to keep your puppy safe.
How much time will your puppy be left alone each day?
What other pets do you have in your home? Please tell me about them. Thanks.
Our Black and Tan Jacks are devoted companions. Are you prepared for a constant "shadow"?
Does anyone in your household have an allergy to dogs? YES NO
Under what circumstances might you be forced to give a dog away?
How did you hear about Aislinge Bray Terriers and our Black and Tan Jack puppies? While searching the web. "Good to hear! Thanks" By word of mouth. "Love This! Thanks" From another breeder. "Very nice! Thanks" Other. "Thanks for your input, it is good to know how you found us!"
Please explain the other place you heard about Aislinge Bray and our Black and Tan Jacks.
Thank you for your interest in an Aislinge Bray Terrier puppy. We appreciate you for taking the time to send us your information. All reservation requests will be replied to within 48 hours. We will try to reply within 12 hours. ** Lately the puppy reservation request forms have been bogged down with robo submissions and sometimes your form does not get to us or is mistook for a robo submission. ** Please also call (607-746-2655), text (607-437-5380) or email me ( BlackAndTanJacks@yahoo.com ). We look forward to hearing from you. Thanks! Sincerely, Lori of Aislinge Bray Terriers