First + Last Name

Email

City

State

Phone Number

Is this your first dog? Is this your first dog? YesNo

Tell us about any dogs you have previously owned and why you no longer own them:

Is this your first Aussie? Is this your first Aussie?YesNo

Do you own any other pets? Do you own any other pets? YesNo

Please list what kind and how many.

Why is this the right breed for you? Please explain.

Do you have a color preference? Do you have a color preference? Blue Merle Red Merle Red Black Either Merle Either Tri No Preference

What do you plan to do with this dog? What do you plan to do with this dog? Agility Obedience Conformation Rally Freestyle Obedience Herding 4-H Junior Showmanship Family Pet Other

Second Choice Color

What gender are you interested in? What gender are you interested in?MaleFemaleEither/No Preference

Have you been in contact with any other Australian Shepherd breeders? If yes, please list their names and kennels.

Will you use a crate to house your dog? Will you use a crate to house your dog?YesNo

Will you be attending training classes with this dog? Will you be attending training classes with this dog?YesNoMaybe

Do you have a fenced in yard? Do you have a fenced in yard? YesNo

What kind of fence do you have?

Where will the dog be housed when you're not home?

How will the dog be exercised and how often?

Can you provide all veterinary care? Can you provide all veterinary care? YesNo

Please provide the name and phone number of your veterinarian:

Do you breed Aussies? Do you breed Aussies? YesNo

Are you a member in good standing with ASCA or AKC? Are you a member in good standing with ASCA or AKC?YesNo

Do you have a website? Do you have a website? YesNo

What is your website's URL?

Please provide the name and contact information of your first reference here:

Please provide the name and contact information of your second reference here:

Please tell us a little about yourself and your family:

Is there anything else you'd like us to know?