To be considered for one of our puppies please copy and paste the

information below in a new email and email me with your answers.

Full name:

Address:

State:

Age:

Home Phone:

Cell Phone:

Email address:

Children's ages:

Will anyone else be living with the pup?

Do you live in a:

House

Condo

Other

Do you have a fenced yard?

If not, have you considered how the dog will be exercised and toileted?

Have you owned a Poodle before?

What animals do you own now?

Veterinarian's name and phone number:

(please contact your veterinarian to release referral information to me)

In what ways will this puppy be enhancing your life?

          For example: Companion / Show Prospect / Obedience / Agility

/ Breeding / Other (please specify) / all the above

What personality are you seeking in a canine companion?

With what size, color, and sex of poodle do you wish to share your home?