Application form

Full Name of you and your spouse if applicable. *

First Name Last Name

Age

E-mail *

example@example.com

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Phone Number

Area Code Phone Number

How did you hear about Classic Creek Aussies?

Do you live in a:

Do you:

Own Rent Live with Parents Other

Household Setting

Rural Suburban Urban

Describe your Homes Activity Level

Busy/Noisy Moderate Comings/Goings Quiet with Occasional Guests

Please List all People Living in the Household (Include Name, Relationship, Gender and Age) *

Do you have any children/grandchildren that live with you or visit? If so what are their ages?

Are all members of your household comfortable around the presence of a puppy that could nip, jump and chew during the training stages?

Yes No

What is you and spouses occupation?

Does Anyone in your Household have Allergies to Animals?

Yes No

Are all members of your Family agreeable to a new puppy?

Yes No

Please List any Pets you have (Please include Name, Breed, Age, Altered, Sex, UTD Vaccines. *

If you don't have any dogs now please tell me about your exposure to dogs and ownership.

Do you have a preference in sex of your puppy?

Male Female No Preference

Do you have a color preference for your puppy?

Yes No

If you do have a color preference what is it and are you flexible ?

Do you plan to spay/neuter your puppy?

Yes No

Our pups are typically sold on a no breed contract, is that a problem?

Yes No

As mentioned above we don't typically sell breeding rights but if you would like to request them please tell us why? Leave blank if not applicable.

In the past 5 years have you had to part with any pet.

Yes No

If yes please explain the circumstances.

Do you agree to crate training your puppy? If not please tell me why.

Yes No

Are you open to puppy classes if needed?

Yes No

Do you have a fenced yard?

Yes No Partial

If fenced, please give details on height, material, # of gates, are gates locked or lockable?

Where will your puppy be kept when no one is home?

How many hours in a day would the puppy be left alone?

What are your plans to exercise your puppy? Please list any parks near by or trails, how many walks a day, approximate length, and activities such as agility.

Do you have any plans for your Aussie? Therapy dog, Agility, Trick dog, Rally O, Herding, Family Companion ect.

What made you decide on the Aussie Breed and do you have any experience with the breed?

Vet Reference: Full Name *

First Name Last Name

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

By sending this electronically, I acknowledge that I have completely read this questionnaire and comprehend it fully.

I understand that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application can result in the void of this application.

I certify that the above information is correct, and I understand that the information will be verified.

Date

Month Day Year

Your name *

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