Name: *
Address: *
Age: *
Work Phone:
Home Phone: *
E-mail Address: *
Children's Ages:
Have You Ever Bred Animals? Yes No
Do You Live In A: Condo House Other
Have You Ever Owned A Poodle? Yes No
Have You Owned Any Other Breed Of Dog? Yes No
Do You Have A Yard? Yes No
Are you willing to give a life long commitment to giving this new addition not only love but the best care that he/she will require as to maintaining a good health program through a licensed vet, a nutritionally balance food diet, exercise, and grooming when required? Yes No
Why do you want to own a poodle?
Why Should I Consider You As A Home For One Of My Poodles?
What size of Poodle and color are you interested in sharing your home with? * Standard Miniature Toy Color
Additional Comments & Questions: