Central Carolina Poodle Club Rescue
Prospective Owner Questionnaire
Online Version

This questionnaire was prepared for the benefit of you, the prospective owner, and for the dog that you plan to have become a part of your family. The following questions will help us match a dog with the proper home based on the prospective owner’s lifestyle and on the rescue dog’s personality and abilities. Please complete the form and submit it, so that you can be placed on a waiting list for a rescued dog.

INSTRUCTIONS FOR COMPLETING THE ONLINE APPLICATION: Please be certain that your e-mail address is included and correct so that we can respond to your application. Applications without complete contact information will get an error message and will not be processed. Please answer every question completely, as incomplete forms cannot be accepted. We need all your information so that we can match you with a suitable poodle.




Your name:

Street Address:

City, State, Zip:

Phone:

Email Address:
    Please check email address for accuracy to be sure we can contact you!

Occupation:

1. Why do you want a poodle?

2. What variety/size of poodle to you wish (Toy, Mini, Standard)?

Do you prefer a male or female?
Male
Female
Either

If your sex preference isn't available, are you willing to adopt a dog of the opposite sex?
Yes
No

What age range will you accept? (For example: 6-10 years, puppy, etc.)

If you're interested in a specific dog that is listed on the web page, which one?

3. Do you have other pets?
Yes
No

What kind of pets do you have?

If you have other dogs, what breed, sex and age are they? And are they spayed or neutered?
Breed Size/weight Age Sex Neutered/Spayed?

How do you think your other pets will get along with a new dog? Do you anticpate any problems?

4. Have you had a pet before? If so what kind?

How long did you have that pet? What happened to it?

3. Have you ever owned a poodle before?
Yes
No

If yes, what happened to your poodle?

4. Who is this poodle for?

If not for you, is this person aware he/she will be getting a poodle?
Yes
No

6. How many adults live in your home?

7. Do you have children? If so, please list their first names and their ages:

8. Does everyone in your family want a dog?
Yes
No

9. Who will be the dog's primary caretaker?

10. Please answer the following questions about your home:
House
Condo
Apartment
Other


Own
Rent
Rural
Suburban
Urban

11. If leasing/renting, does your lease allow pets?
Yes
No

12. Do you have a fenced yard?
Yes
No

13. Do you have a pool?
Yes
No

If you have a pool, is it enclosed in a separate fenced area?
Yes
No

14 Describe how your dog will live (indoors, outdoors, etc.):

15. Approximately how many hours a day will your dog be left alone?

Where will the dog stay while no one is home?

16. During the day while someone is home, where will your dog be kept?

17. Where will the dog stay at night?

18. How often do you travel?

Where will the dog stay you're traveling?

19. Do you realize that a poodle may live for 10-20 years?
Yes
No

Are you committed to caring for a dog for these 10-20 years?
Yes
No

20. Are you aware of the grooming requirements of Poodles?
Yes
No

21. How do you expect the dog to behave in your home?

22. What kind of activities do you plan on doing with your dog? (Housedog, outdoor dog, companion, nothing, agility, obedience, flyball, tracking, hunting/retrieving, etc.)

23. Some rescue dogs may have behavorial problems due to their past situations. Are you willing to attend obedience and other types of classes to train your dog, and to deal with any behavioral issues the dog has?
Yes
No

24. Are you agreeable to returning the dog, should some unforseen circumstance arise wherein you would no longer be able to keep the dog?
Yes
No

Under what circumstances would you return your adopted poodle?

25. CCPC tries to conduct applicant home visits whenever possible. Would you be willing to allow us to visit your home?
Yes
No

When is the best time for someone to visit you?

26. How did you find out about us?

27. Please list two character references whom we may contact. Email addresses are preferred. (If no email, please list phone numbers.

28a. Do you have a veterinarian whom we could contact? If so please list name and telephone number.

28b. If you don't currently have a veterinarian because you don't have a pet, please list the name of the vet you are likely to use for your adopted poodle.

Have you read our FAQ page? (If not, please do so now)

29. Do you have any questions?

30. May we forward your application to other rescue groups?

Please note: The adoption fee for CCPC poodles is $200, unless otherwise stated. (This applies only to dogs in CCPC Rescue. Other dogs, fostered by other rescue groups, may have different adoption fees. Please inquire if you have questions about this.

COMPLETED BY (your name):

DATE: