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Picket Fence Poodle Rescue

Minnesota Poodle Rescue Rehome

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Application for Adoption Form

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Name of Poodle you are interested in adopting *

Your Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

If you reside outside of the United States, please contact us and we will send you an application to fill out.

Email *

days know and

Phone *

List names and relationship to you of ALL adults living in your home. *

This Includes Spouse, Partner, Relatives And Roommates. If no other adults live in your home, please write None.

If there are children living in the home or occasionally visiting, please list their name(s) and age(s). *

If no children live in your home, please write None.

Dwelling *

Home
Apartment
Condo/Townhouse/Duplex
Mobile Home

Rent or Own *

Rent
Own

Has your Landlord agreed in writing to allow you to have a dog on the premises?

Yes
No

Do you have a securely fenced yard? *

Yes
No

NOTICE: We DO NOT accept "Invisible Fencing." STOP HERE if that is what you use.

How do you plan to keep the poodle from roaming, being run over by an automobile, or being stolen?

Who will be the primary caregiver to the Poodle?

Do you work outside the home? *

Yes
No

What hours and days do you work? *

Will someone be able to let the dog out while you are at work? *

Yes
No

Or where will the dog be while you are at work? *

Do other animals live in your home? *

Yes
No

What are their weight(s), breed(s), temperament(s), and age(s)?

Have you owned a dog in the past? *

Yes
No

Which breed? When? For how long? What became of the dog?

Please describe why you want this poodle from Picket Fence Poodle Rescue *

In the case of a life altering event, are you or a family member willing to return the poodle to us? *

Yes
No

We understand that unforeseen circumstances arise, and you or your family might not be able to keep the poodle. Please be sure to make those arrangements with your family or friends now.

Please list your Veterinarian name and telephone number to be contacted *

Personal Reference 1 (Name, relationship to you, telephone/email) *

Personal Reference 2 (Name, relationship to you, telephone/email) *

If you are interested in adopting a Standard Poodle, please provide the name and number of your groomer

Is there anything else you would like us to know about you? *

Do you have any questions about the dog you are applying for? *

I certify that the information entered on this application is true. Enter your name and date. *

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