Full Name:

Mailing Address:

City: State: Zip Code:

Home Phone: Cell Phone: Other Phone:

E-mail Address:

Occupation:

I would prefer a: Male Female Either   Color Preference: Red Apricot

Are you interested in a Standard Poodle or a Golendoodle?                         

Do you presently own any animals? Yes No
If yes, please tell us about them:

Have you previously owned a dog? Yes No

If so, Do you still have your dog?  If not what happened to him/her? 

Do you own or rent your home? Own Rent

If you rent please provide landlord contact information.

Do you have a fenced yard? Yes No

Do you agree to keep your dog in the house with your family and never kenneled outside?   Yes

If you cannot keep your new companion, do you agree to contact us and either allow us to help you place him/her

or return him/her to us at no cost? Yes No

Please tell us about yourself and your family.

(Ex: children, ages, activities, what your looking for in a puppy, etc)

We will use this information to recommend the perfect puppy for you.

I understand that this application is subject to approval and that all puppies are sold on AKC limited registration

(spay/neuter) contract unless otherwise agreed upon. Yes No

I understand that a $250.00 non-refundable deposit is required to reserve a puppy. Yes No

Please use this area for any additional information, comments, or questions you have.