Your Name**
Your E-Mail Address**
Your Address
Your Phone Number**
Your City, State, and Zip
How did you find us?
Friend
Breeder Referral
Website
Other
Do you prefer a male or a female?
Do you have a color preference?
Male
Female
Black Tri
Blue Merle (I do
not breed reds at this time)
Would you consider a puppy of another color or sex if your preferences
are not available?
Yes
No
What activities do you plan to do with your Aussie puppy?
(Check all that apply)
Conformation
Obedience
Herding
Agility
Pet
Our pet puppies are sold with spay/neuter contract. Would you have a
problem with this? If Yes, why?:
Have you spoken to other breeders? If yes, please list them.
Are you currently on the waiting list for any other litters?
Yes
No
Are you a member of ASCA?
Yes
No
Are you a member of an affiliate club? If yes, please list them.
Are you a member of an AKC club? If yes, please list them.
Do you have children?
Yes
No
If Yes, please list their ages below:
Are you aware Aussies are medium dogs that shed several times a year?
Yes
No
Do you live in apt, house, or on acreage?
Apartment
House
Acreage
Do you own or rent your home?
Rent
Own
If renting, do you have your landlords permission to keep a dog? Name
and phone number of landlord.
Do you have a fenced yard? If no, how will you provide security when it
is outside or you are away?
Where will your puppy spend it's days? And nights?
Will it have regular contact with your family?
Yes
No
Will you be willing to attend obedience classes?
Yes
No
Have you ever owned an Australian Shepherd before?
Yes
No
What other breed of dog have you owned? (If you haven't owned a dog
before, please state.)
Do you currently own a dog?:
Yes
No
Who will have primary responsibility for the care of the puppy?
Do all family agree to adding a puppy to the family? If no, who is in
favor and who is not?
What is the name and address of veterinarian?
Have you ever given up a dog before? If so, why?
What type of personality are you looking for in your dog?
Please give other information that will help us to get to know you and
your
needs with respect to placing a puppy most suited to your family.