Only Money Orders, Cashier Checks or Credit Cards (add 4%): please.

      1 st Call House- (315) 761-4091 and leave message......... Cell (315) 762-5459

Please ask your questions... before Reserve or Deposit is sent. It is non refundable.

Good for only one year from date received.   CHECKS MADE OUT TO;  LAURA MILLER 

Mail to:

              Laura  Miller    6893 Jug Point Road,  Durhamville, New York 13054


  Reservation & Deposit Information Sheet   

Reserves and/or Deposits must be used with in one year: and are non-refundable. 

                   CHECKS MADE OUT TO;  LAURA MILLER

Date-    Website:  Puppy play name _______________

** Reserve in the amount of  $ ______________ Reserves are 100.   

Reserve entitles you to pick in order, by picture, Only.


** Deposit is to hold a puppy till pick-up: amount is half  $  ______________

Deposits are half the puppy price...Limited AKC is available with each puppy.

 Name    \


City, State and Zip Code           

   Phone Number and Cell Number          



E-mail   Had a Shih Tzu before? ___Yes or No___ 

 Please pick one:    Male      Female         Either sex is O.K.     Not sure

Please pick one:     Parti- Colors (Wh. w/ any color)   Solid Color  Not sure  

Please pick color:     Gold    Brindle    White (Mostly)    Not sure

                                Chocolate/Liver       Red/ Black Mask    __ Black & White

                                Solid Black (1200.)  __ Solid White (1200.)

All Solid Blacks and Solid Whites are full price of 1200. But maybe reserved before born.


Special : Reservations will receive a FREE NO STUFF TOY.

Do you have children under 12?____Yes or No___         

If there is anything you feel I should know!



If I change my mind, I will lose all my money! Ask questions before reserve or deposits sent. It is

non- refundable.     Signature_____________________________________________