Your Name:

Address:

City:

State:

Zip:

Day Phone:

Night Phone:

Email:

Your age: -SELECT- under 18 18-25 26-50 50+

Any other Adults in your home:   -SELECT- YES NO

Please provide us with a personal reference? (Vet or other reference we may contact)

Do you have children?
-SELECT- YES NO

If so: how many and what ages?

Is anyone allergic to pets or dander?
-SELECT- YES NO

Are your children properly trained as how to handle pets in general?
-SELECT- YES NO  

AIRPORT TO SHIP TO:

Do you agree that, if you for some reason can not keep or care for this dog, you will contact us about relocation and allow us first right of refusal?
-SELECT- YES NO

Will you provide basic obedience training?
-SELECT- YES NO  

Will you provide us feedback on your pup’s development?
-SELECT- YES NO  

Please indicate if you are looking for a dog that is
-SELECT- Pet Breed/show

COLOR – please indicate your preference
-SELECT- RED MERLE BLUE MERLE NO PREFERENCE RED TRI BLACK TRI RED BI BLACK BI

SEX
-SELECT- Female Male NO PREFERENCE

WHAT AREA(S) OF INTEREST WOULD YOU LIKE TO PURSUE WITH YOUR AUSSIE?
-SELECT- AGILITY OBEDIENCE SHOWING COMPANION TRICK DOG A 4-H PROJECT WATCH DOG BREEDING HERDING FLYBALL THERAPY DOG HIKING/ WALKING OTHER

IF OTHER

DO YOU HAVE A TIME FRAME IN WHICH YOU WISH TO ACQUIRE A PUPPY/DOG?
-SELECT- YES NO

HAVE YOU OR YOUR FAMILY EVER OWNED AN AUSSIE BEFORE?
-SELECT- YES NO

IN YOUR OWN WORDS, WHAT ARE YOUR PLANS FOR THIS AUSSIE?

LIST ANY INFORMATION YOU THINK WILL BE HELPFUL FOR US TO CHOOSE AN INDIVIDUAL AUSSIE FOR YOU:

WOULD THE PUP/DOG BE ABLE TO GO OR BE WITH YOU MUCH OF THE TIME?

WHO WILL BE THE PRIMARY CAREGIVER?

WHO WILL BE THE SECONDARY CAREGIVER?

WILL YOU BE TRAINING OR HANDLING THIS DOG ALSO?
-SELECT- YES NO

What are your reasons for wanting an Australian Shepherd?

Are you aware that miniature Aussies require moderate exercise and shed seasonally?

IF YOU HAVE OTHER PETS, BRIEFLY TELL US ABOUT THEM

WHAT TYPE OF RESIDENCE?
-SELECT- HOUSE TOWNHOUSE APARTMENT

WHERE WILL THE DOG STAY WHILE AT WORK OR OUT OF THE HOUSE?
-SELECT- BASEMENT LAUNDRY GARAGE DOG RUN FREE IN HOUSE FREE IN KITCHEN FREE IN YARD OTHER

IF OTHER

WHAT YARD FACILITIES DO YOU HAVE FOR YOU NEW AUSSIE?
-SELECT- UNFENCED KENNEL RUN FENCED YARD OTHER

IF OTHER

ABOUT HOW MUCH TIME WILL THE DOG SPEND INDOORS?
OUTDOORS?
ALONE WHILE AT WORK?

HOW DO YOU PLAN TO PROVIDE EXERCISE FOR YOUR PUPPY /OR DOG

MINI AUSSIES, JUST LIKE THEIR LARGER COUNTERPARTS, COME IN A
RANGE OF TEMPERAMENTS, BODY TYPES AND COAT TYPES. WHAT IS
YOUR IDEA OF A PERFECT MINI?

He is your friend, your partner, your defender, your dog.
You are his life, his love, his leader. He will be yours,
faithful and true, to the last beat of his heart. You owe
it to him to be worthy of such devotion." -- Unknown

Occasionally we have a pup of outstanding quality for which we would like to
retain breeding rights in the case of a female for up to two litters.  The dog would
be held in CO-ownership until the obligation would be fulfilled at which time we
would sign off of the CO-ownership.  In the case of a male dog, would you be willing to allow us a set amount of stud services to be agreed upon at the time of purchase.

Would you be interested in a situation such as this? -SELECT- YES NO