Copy of Dog purchase application

KC poodles of PA Purchase Adoption Application

Full name

Occupation

Address

Daytime Phone

Evening Phone

Best time to call

Email address

example@example.com

How many adults are there in your family their relationship to you?

How many children and ages?

What type of home do you live in? Single, family town home, apartment, farm, etc

If you rent please give the rules governing pets and the landlords name and number

(by providing this information you are allowing KCpoodles to contact your landlord please inform them of this call so they will speak with us)

Is everyone in agreement with the decision to adopt a dog?

Do you have time to provide adequate love and attention?

What are your daily plans for exercise?

Are there any smokers in the home?

What other pets do you have? specify type and number

Have you ever surrendered a pet If so why?

Have you ever had a pet euthanized If so why?

Have you ever lost a pet to an accident?

How do you discipline your pets?

Do you have a regular veterinarian?

Veterinarians name

Clinic Name

Clinic Address

Clinic Phone

(Providing KCpoodles with this information you are allowing KCpoodles to call your vet. Please call your vet and ask them to authorize the release of information to KCpoodles)

About the Dog You Wish to Adopt

What is your idea of an ideal dog and why?

Desired age

Describe your ideal dog

Desired Size

Desired breed

Breed you would not adopt

Desired sex

Where will the dog spend the day? describe

Where will the dog spend the night? describe

Number of hours average dog will spend alone

When the dog goes out how do you plan to supervise?

Do you agree to provide regular health care by a Licensed Veterinarian?

Please list someone who is familiar with both you and your pets.

Name

Address

Phone

Name

Address

Phone

Relationship relative neighbor friend etc

How did you find out about us?

All of the information I have given is true and complete. This dog will reside in my home as a pet. I will provide it with quality dog food, plenty of fresh water, indoor shelter, affection, annual physical examination and vaccinations under the supervision of a licensed Veterinarian.

Date