Puppy Form

As a breeder, I have responsibilities that include:
1. Limited breeding of healthy dogs of sound temperament.
2. Breeding with the goal of improving the Australian Shepherd breed.
3. Placing my puppies in responsible homes and doing my best to prevent unwanted dogs from going to the shelters or living in an abusive environment.
One way in which I facilitate the above is to ask my potential puppy families to answer this questionnaire. Thank you for your assistance!

Our stand on Mini Aussies

The Miniature Australian Shepherd, North American Shepherd, North American Miniature Australian Shepherd, Miniature American Shepherd, and/or Toy Australian Shepherd breeds are not recognized as a variety of Australian Shepherd by ASCA. The club considers such dogs to be a distinct and separate breed and will not accept them into its registry.
Contact Information
Contact Person*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
E-mail*
Pet Information
Why are you considering an Aussie?
Have You ever owned an Aussie?

YesNo
Do you know much about Aussies?
Are you looking for a male or female?

MaleFemale
Why?
Why are you considering the gender picked above?
Are you interested in breeding your dog?

YesNo
Are you looking for a pet or are you planning to show?

PetAgilityConformationObedience/RallyHerdingOther
If you are interested in a show dog, have you attended any dog shows and are you aware of the costs and time involved in showing dogs?
Do you have any other pets and what are their ages and breeds?
Have you had any pets in the past? If so what happened to them?
Where will your dog stay?
How about while you're at work?
While you're asleep?
What type of dog food will you feed?
Are you familiar with the health problems created by feeding "grocery store" dog food?

YesNo
Are you Familiar with crate training?

YesNo
If you are interested in a pet puppy, do you have any objections to spaying or neutering your dog?

YesNo
Personal Information
Do you have any children? If so what are their ages?
Do you live in a house or apartment?
Do you own or rent?
If you rent, does your landlord have any objections or concerns about you having a dog? If so explain.
Do you have a fenced yard? If so, what type of fence and how tall is it?
Would you have any objections to signing an agreement that in the future, if for any reason you do not want or cannot keep this dog, that it will be signed back over to the breeder? If so explain.
References
Your Veterinarians Name

First NameLast Name
Your Veterinarians phone number

Area CodePhone Number
Can you supply any references? (Preferably professional):
Name

First NameLast Name
Phone Number

Area CodePhone Number
Name

First NameLast Name
Phone Number

Area CodePhone Number
Other Information
Which Aussie are you interested in? Is there any other information you need to provide?
Enter the message as it's shown*
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Contact Information

Pet Information

Personal Information

References

Other Information