Miniature Poodle Application
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone Number
-
Area Code
Phone Number
Work Number
-
Area Code
Phone Number
Cell Number
-
Area Code
Phone Number
Best Phone to Reach you
Home
Work
Cell
Email
example@example.com
Your Age
Ages of Others in the Home
Relationship to You
Which Miniature Poodle are you Interested in?
Angel
Shadow
Either
Both of them
Do you have a Fenced in Yard?
Yes
No
Do you live in a gated community?
Yes
No
Have you owned a poodle before?
Yes
No
Do you have another Dog in your Home?
Yes
No
Are you currently employed?
Full Time
Part Time
Work at Home
Retired
How many hours per day will the dog be left alone?
1
2
3
4
5
^
7
8
9
10
11
12
13
14
15
16
17
18
How many children are in the home?
0
1
2
3
4
5
6
How many adults are in the home?
1
2
3
4
5
6
Can you afford the grooming, veterinary expenses that taking care of a Poodle requires?
Yes
No
Please tell us more.
Submit
Should be Empty: