Personal Information:
First & Last Name:
Street Address:
Mailing Address:
City:
State: Zip Code:  - 
Home Phone:   - 
Work Phone:   - 
Email:
Environment Information:
Your age:  
Have you ever bred animals? Yes No   If Yes, 
Have you ever owned
any other breed of dog?		 Yes No   If Yes, 
Have you ever owned a poodle?   Yes No
Do you live in a... House Condo Other   
Do you have a fenced yard?   Yes No
Detailed Environment Information:
  • Are you willing to spay or neuter your Highview Poodle?
    Yes No

  • What is / are your primary reason(s) for wanting a Highview Poodle?
    (check all that apply):
    Pet / Companion
    Show Prospect
    Obedience
    Agility
    Other (describe below)


    • Breeding
    If you selected Breeding, please tell what breeds you now breed or have bred
    in the past and why you would want a Highview Poodle for breeding purposes.

  • Who Else Lives in the Home? (Including children's ages if applicable)
         

  • If you work outside the home, how many hours a day will the dog be alone, and how will the dog be contained while you are gone?
         

  • What other animals are in the family?
         

  • How do you feel about spending money for professional dog training?
         

  • How will you attempt to train your dog and discourage unacceptable behavior, and encourage proper behavior?
         

  • Why do you want to own a poodle?
         

  • 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 should we consider you as a home for one of our poodles?
         
  • Additional Questions and Comments.
         

Additional Information:
  • Veterinarian's name, address, and phone number:
    Name:
    Address:
    Phone number:   - 
  • Three references names, addresses and phone numbers:
    Name:
    Address:
    Phone number:   - 


    Name:
    Address:
    Phone number:   - 


    Name:
    Address:
    Phone number:   - 
We take the utmost pride in our care and concern of finding the perfect home for our perfect Highview Standard Poodles. We appreciate your cooperation in this matter.
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Blain Highview Standard Poodles breeds and produces only pure, high quality poodles and never cross breed to produce "designer breeds


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