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First Name
Last Name
Address
City/State/Zipcode
Telephone Number
Email Address
If you rent, can you provide a letter from your landlord granting permission for the dog?
Yes
No
If you have children at home, please submit ages.
Will there be someone home with the puppy during the day?
Yes
No
Do you have a fenced in yard?
Yes
No
Sex preference?
Male
Female
Have you ever owned a poodle before?
Yes
No
Are you aware of a poodles grooming needs?
Yes
No
Where will the puppy sleep at night?
Please list your Veterinarian for care reference.
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