<p>KINGS VALLEY COLLIES, LLC 39968 WARD ROAD  KINGS VALLEY  OREGON 97361  USA</p><p>INFO/RESERVATIONS</p><p>The information you share about yourselves, your home, and your lifestyle will help us select the Collie that best meets your family's expectations. Thank you for your trust and cooperation! First Name: Last Name: Address: City: State: Zip: Home phone: [ ] Fax [ ] E-mail: Work phone: [ ] Fax [ ] E-mail: Please tell us the names, ages, and occupations of the other members of your family: We are located in: City We live in: Our own home Fenced areas: Front yard Back yard ? Property fence ? Other? Dog door? Yes Areas in the home inaccessible to dogs: accessible: </p><p>Who is at home during the morning? afternoon? evening? Who will feed? groom? train? play? with the dog? Other pets in the family: Will this be your first Collie? What do you like most about Collies? What would you dislike? Any problems with previous dogs? </p><p>What are your plans for the new Collie? Showing Breeding Obedience Tracking Agility Herding Carting Sledding Skiing Backpacking Protection Childcare Therapy Service/ Assistance Work Family Pet Other: </p><p>We would like: A young puppy An older puppy A young adult A mature adult Male We would prefer a Rough coat Sable Tricolor Blue Merle No Preference </p><p>Who referred you to Kings Valley Collies? Who is your veterinarian? Name of clinic: City: Are you ready for a Collie now? or at a later date? When? Anything else you think we should know about you? </p><p>Date of visit Date of reservation Date of Deposit Amount of Deposit </p><p>Please save this form, and then send it to us at [email protected] as an attachment in an email. Reservations accompanied by a $200 deposit will be honored in the order received. You can use the PayPal link on the website to pay. Deposits are deductible but non-refundable. Thank you again. Your interest in our Collies is greatly appreciated! – Leslie </p><p>[email protected]  WWW.KINGSVALLEYCOLLIES.COM  541-929-2100  FAX 541-929-4593</p>