I would greatly appreciate it if you could take a moment to fill out this questionnaire so that I can get
to know you a bit better.

Your Name?



Your Phone Number?



Email

What is the best way to contact you? (phone or email)

Do you currently own a maltese?
Yes

No  

Have you ever owned a maltese before?

Yes

No  

Are you aware of the extensive grooming your maltese may require if you choose to
allow your maltese' coat to grow?

Yes

No  

Do you own any other animals at this time?

Yes

No  

If yes, could you please list quantity, species, and breed?
 

Do you have any small children at home at this time?

Yes

No  

If your answer was yes, could you please list their ages?
(Please keep in mind that small children and maltese can sometimes be a
dangerous combination,and my primary goal is to
place my maltese into the best and safest homes possible)

Do you prefer

Male    

Female

    Undecided 
 \

Would you be interested in an older puppy? (six months or older?)
  Yes

   No

      Maybe

Please hit fetch and you will be contacted shortly. Thank you for your
interest in MaLo Maltese!