Feedback Form

If you are interested in owning a Tibetan Terrier or you already own one and would just like more information, please fill out this form and it will be sent to us and we will respond as soon as possible.We would like you to be aware that all info submitted here is the property of KhamRa Kennels and will not be sold or given to anyone. Thank you.

Your Name:
Address:
Address 2:
City, State, Zip:
Country
   
Phone (day): Phone (fax):
Phone (eve) : Phone (work):
Phone (cell): Phone (other):
How would you like to be contacted?    

E-Mail:
What sex are you looking for?    

What age are you looking for?    

Color Preference?    

How soon are you looking to get a Tibetan?    

Describe yourself / family / children / other pets
How are you going to train your Tibetan Terrier?

Is someone home during the day?       

If not, what arrangements can be made to assure the comfort and care of your puppy?
How did you hear about KhamRa web site?
Do you have a fenced yard? Yes No
Do you have an Electric Fence? Yes No
Will leash walk? Yes No
Will let dog out in yard? Yes No
Would you like to be on our mailing list? Yes No
 

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