Waiting List
Please print this form, fill out completely and don't forget to sign, date and include this form
along with your deposit for $200.00.
made payable to: Leea M. Knight
Name_________________________________________________
First M Last
Address_______________________________________________
City ______________________ St__________ Zip____________
Home Phone: ________________________
Work Phone:_________________________ Ext:____________
Cellular:____________________________
Email address:_________________________
Please let me know the following
SIZE: Tiny Tea Cup / Imperial / Standard / Any
SEX: Male / Female / Any
COLOR:
This deposit of $200 places me on the waiting list of A Breed Above Shih Tzu for the next
available puppy. I understand that requests will be filled on a first come first serve basis
and that I will have one year from the signing of this contract to find my Shih Tzu puppy.
This deposit is non-fundable if I should change my mind.
I have read this form, understand it, and agree to the terms therein.
Signature_______________________ Date___________________
SEND TO: Leea M Knight
A Breed Above Shih Tzu
314 Depot Street
PO Box 802
Panama, IL. 62077
