| Name:* |
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| Address: |
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| City: |
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| State
or Province: |
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| Zip
Code or Postal Code: |
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| Home
Phone:* |
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| CellPhone: |
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| Email:* |
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| Occupation: |
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| Do
you own or rent your home? |
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| How
long have you lived at this address? |
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| How
large is your yard/or how many acres? |
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| Do
you have a fenced yard? |
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| If
so, what type of fencing? |
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| If
you do not have fencing, how will you handle the puppies exercise and
toilet duties? |
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| How
many adults and children in household? |
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| Ages
of children? |
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| Do
you own other dogs? |
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| .If
yes, describe breed, sex, and age: |
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| .If
you own other dog(s) are they neutered or spayed? |
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| If
you own cats are they declawed? |
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| If
you own a dog(s) and/or cat(s) please give the name, address, and phone
number of your veterinarian. |
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| Have
you owned an Australian Shepherd before? |
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| .Why
did you choose this breed? |
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| .How
many dogs have you owned in the last ten years? |
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| If
you have owned dogs in the last ten years that are not presently living
with you, what happened to dog(s) and be specific. |
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| Will
the puppy reside in the house? |
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| If
you work how will the puppy spend its days? |
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| How
will the puppy spend the night? Crated or uncrated? |
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| How
many hours on the average will the dog spend alone per day? |
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| List
all plans for this dog: Pet, Guard, Herding, Obedience, Breeding, Conformation,
Agility, Other. |
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| Please
provide any additional comments you would like to make. |
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