Form
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are you employed? If so, where?
Do you Own or Rent your home?
Own
Rent
Other
Do you have a fenced in backyard?
Yes
No
Underground Fence
How many people are living in the home?
Do you have any kids? If so, what ages?
Do you have any other pets? If so, what kind?
Have you ever had to rehome a dog? If so, explain:
Have you ever owned an Australian Shepherd?
Why do you want an Australian Shepherd?
Are you interested in a Male or Female?
Male
Female
No Preference
What color are you interested in?
Blue Merle
Red Merle
Black Tri
Red Tri
Black Bi
Red Bi
No Preference
Who will be primarily responsible for the puppy?
How long will the puppy be left alone a day?
What flea/tick and heartworm prevention do you plan on using?
How do you plan to exercise/enrich this dog?
What are your plans for puppy if you travel?
What would your ideal Australian Shepherd be like? Please describe ideal energy level/sociability/demeanor.
Do you plan on crate training your dog?
Is there any reason why you wouldn’t be able to care for a puppy now and/or in the future?
Please provide 1 personal reference:
Please provide current Veterinarian name and number (If Applicable):
How to you plan on receiving your puppy?
Meet at Breeders
Meet Halfway
Delivery
Airport Pickup
Submit
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