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Name: |
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Street Address: |
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Street Address (cont.): |
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| City, State and Zip Code: |
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| Home Phone: |
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| Cell Phone: |
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| Work Phone: |
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| Fax: |
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| E-Mail Address: |
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| Website: |
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How did you
find us?:
(Referral from another
buyer, website, etc.) |
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| Have you
ever owned an Australian Shepherd before?: |
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| What made
you decide to purchase an Aussie?: |
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| Which do
you prefer?: |
Male
Female
Either |
| Why?: |
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Do you have a
color preference?:
If so, what
color?: |
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| Would you consider a
puppy of another color or sex if your preferences are not available?: |
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| What is the time frame
you would like to get your new Aussie in?: |
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| Do you
plan to participate in any of the following activities with your
Aussie?: (Check all that apply) |
Agility
Conformation
Obedience
Herding
Tracking
Flyball
Therapy
Breeding |
| Other?: |
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| If you are not planning
on breeding or showing, would you be willing to have your Aussie spayed
or neutered?: |
Yes
No |
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All our
pet/companion puppies are sold on ASCA/AKC limited registration and
spay/neuter agreements.
Do you have a problem with this?:
If so, why?: |
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What other
breeds of dog have you owned?:
(If you haven't owned a
dog before, please state) |
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| Do you
still own the dog (s) mentioned above?:
If not, what happened to the dog (s)?:
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Do you
currently own any other animals (non-canine)?:
If yes, please
list them here: |
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| If you currently do not
own any dogs, can you tell me about your past exposure to dogs and dog
ownership?: |
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| Do you
have children? |
Yes
No |
| If yes,
please list their names and ages and give me a brief idea of their
exposure to dogs: |
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| What are
your plans for housing and exercising your Aussie?: |
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| On
average, what do you plan to spend per year on food, veterinary care,
etc. for your Aussie?: |
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| How much do you expect
to pay for your Aussie puppy?: |
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Have you
spoken with any other Aussie breeders?:
If yes, please
list them here: |
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| Are you
currently on a waiting list for any other litters?: |
Yes
No |
| Are you at
all interested in being contacted about rescue dogs or older dogs
needing placements if we should come across a dog that we feel would
suit your needs?: |
Yes
No
Maybe |
| Do you own
or rent your home?: |
Own
Rent |
| How long at this current
residence? |
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| If
renting, do you have your landlord's permission to keep a dog?: |
Yes
No |
| Do you
have a totally enclosed fence in your yard?: |
Yes
No |
| Fence height and type?: |
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| Where will
this dog spend the day?: (Check all that
apply) |
Loose
indoors
Crate
Basement
Garage
Fenced
yard
Kennel
run
Loose
outdoors |
| Other?: |
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| On
average, how many hours a day will this dog spend alone?: |
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| Where will
this dog spend the night?: (Check all
that apply)
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Loose
indoors
Tied
up outside
Crate
Basement
Garage
Fenced
yard
Kennel
run
Loose
outdoors |
| Other?: |
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Have you ever
given away a dog to a friend, family or shelter?:
If so, why?: |
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| What type
of personality are you looking for in your dog?: |
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| Please
list two references (veterinarian, person active in dogs or close
acquaintance preferred): (Please include
phone number and e-mail address) |
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