Application

Poodle Rescue Connecticut
and surrounding New England States

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Application
Please complete entire application and hit submit. We will review your application and be in touch as soon as possible.

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	Name
	Address
	Address2
	City
	State
	Zip Code
	Work Phone
	Home Phone
	FAX
	Email
	Name or description of pet(s) in which you are interested:
	Your age:
	Ages of children in household:
	List pets currently in your household. Please include names of pet(s):
	Are your current pets spayed/neutered and current on all vaccinations?
	List previous pets (include names) and what happened to them:
	Are you a renter or a homeowner? Please state whether you rent/own a single-family home, multi-family or apartment/condo.
	If you are a renter, please provide landlord's name and telephone number so that we may confirm permission to keep a pet:
	Do you have a yard and, if so, is it fenced on all sides?
	If you have a fenced yard, what height is the fence?
	Where will the pet be kept when you are at home? Where will the pet be kept when you are away from home?
	Where will the pet sleep at night?
	How will you provide for the pet's exercise/toilet needs?
	How many hours a day will your pet be left alone?
	If you are adopting a dog, are you prepared to housebreak it? If so, what method will you use?
	What obedience training, if any, will you provide?
	What do you estimate is the yearly cost of food, supplies and emergency and routine veterinary care?
	We require a reference from your current veterinarian and grooming salon. Please provide their contact information. As a courtesy, you may wish to let them know we will be calling.