Epiphany Australian Shepherds Puppy Application
Who is filling out this form?
A Junior (age 8-18)
An adult (age 18+)
How many adults live in your home?
How many children live in your home?
Who will be this puppy's primary care giver?
Are all family members in agreement about bringing a new puppy home?
Yes
No
Do you have any other animals? If yes what type, breed, and age?
Have you ever rehomed a pet? If yes, please explain.
If the need ever arises to rehome an Epiphany dog, do you agree to return them back to me?
Please provide your veterinarians name and phone number
Do you own or rent your home?
Own
Rent
What type of housing do you own? (Ex: Mobile Home, house, apartment)
What is your occupation?
Do you have a fully fenced yard? Height of fencing?
Where will the dog stay?
Inside
Outside
A combination of both
How many hours a day will the pup be left alone?
Do you plan to crate train your puppy?
Where will the dog stay when no one is home?
Why do you want an Australian Shepherd?
What is your plan for your pets? Choose all that apply
Companion
Breeding
Conformation
Agility
Herding
Dock diving
Obedience
Rally
Barn hunt
Fast CAT
Therapy Dog
None
A little bit of all
Other
Do you want to breed your Aussie in the future?
Yes
No
Maybe
Other
What color preference do you have?
Blue Merle
Black Tri
Red Tri
Red Merle
It doesn’t matter
Other
What sex puppy do you prefer?
Male
Female
It doesn’t matter
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Date Signed
-
Month
-
Day
Year
Date
Signature
By signing this you confirm all statements made above are true to the best of your knowledge.
Submit
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