First Name:
Last Name:
Email Address:	Required
Phone Number:	Required
Is this your first Dog?	Yes No
Tell us about any dogs you have previously owned and why you no longer own them:
Is this your first Aussie?	Yes No
Do you own any other pets?	Yes No
Please list what kind and how many.
Why is this the right breed for you? Please Explain.
Do you have a color preference?	Blue Merle Red Merle Red Black
Are you open to another color, if a pup is not available in your desired color?
What gender are you interested in?	Male Female Either
What do you plan to do with this dog?	Agility Obedience Conformation Rally Freestyle Obedience Herding 4-H Junior Showmanship Family Pet Other
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?	Yes No
Will you be attending training classes with this dog?	Yes No Maybe
Do you have a fenced in yard? What kind?
Where will the dog be housed when you're not home?
How will the dog be exercised?
How often?
Can you provide all veterinary care?	Yes No
Do you breed Aussies?
Are you a memer in good standing with ASCA or AKC?
Do you have Website?
Please provide at least two references below.
List your references' contact info here:
Name and phone number of your veterinarian:
Please tell us about yourself and family:
Is there anything else you would like us to know?
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