Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Cell Phone

(###)

###

####

Name or description of the pet(s) in which you are interested:

Do you have experience with Poodles or other dog breeds?

How old are the adults in the household?

How old are the children in the household?

Do you rent or own your home?

Own

Rent

Type of property:

Single Family Home

Multi Family Home

Apartment/Condo

Is the yard fenced on all sides?

Fenced

Not Fenced

Where will your pet be kept when you are at home?

Where will your pet sleep at night?

How many hours a day will your pet be left alone?

Are you prepared to housebreak this pet?

Yes

What is your estimate of the annual cost of food, supplies, routine veterinary and emergency care for this pet?

We require a reference from your current veterinarian

Veterinarian Name

First Name

Last Name

Veterinarian Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Veterinarian Phone

(###)

###

####

We require a reference from your current groomer

Groomer Name

First Name

Last Name

Groomer Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Groomer Phone

(###)

###

####

Enter any other information you wish us to have here. Personalization helps us to know you better.

Adoption Application

Please complete the entire application. After review, one of our volunteers will be in touch as soon as possible.

We will call the Veterinarian and Groomer that you list as references. You MUST notify them in advance to authorize release of your information to us as part of this application.