Email Address:   *Required Field*

Your Name:

Phone Number:

Address:

City, State, Zip:

Are you currently interested in a specific Aussie we have listed? (If yes, which one?)

How many people in your home? (Please list names & ages)

Why do you want an Aussie?

Do you currently own any Aussies? (If so, how many?)

     (If yes) Where did you obtain them from?
    
     (If yes) Are they altered or intact?
    
     If intact, have you ever bred them? (If yes, how often?)
    

Have you owned any Aussies in the past?
(If yes, what happened to them & where did you obtain them from?)

Do you currently own any other pets? Please describe:

Have you ever bred a litter of dogs? (If yes, give a brief description.)

Are you interested in breeding your new Aussie?

Are you willing to spay or neuter your new Aussie if you are purchasing a pet?

Do you have a fenced in yard?

Do you have a preference for age, sex, color, or other traits?

Where will your Aussie spend his time? (Inside the home, yard, kennel run, crate etc.)
If inside the home will he have full run of the house or will he be restricted?

What kind of research have you done on the Aussie?

Have you ever surrendered a dog (to a pound / humane society / rescue group / etc.) for any reason? (If yes, what was the reason?)

How did you find us? (search engine, other website, referral, etc. & Who)

Do you have any additional questions/comments for us?

We Require three references:
(vet, breeder, friend, etc - If you currently own a pet, Must supply vet)
Please include contact info: Name, Phone, and eMail if possible.

Your Vet's Reference Information:
Clinic Name: Vet's Name: Phone: eMail:

Second Reference:
Name: Phone: eMail:

Third Reference:
Name: Phone: eMail:

You're Almost Done!

Please be honest - there are no "right" or "wrong" answers. The information you provide will allow us to get to know you better, and help us to match the right puppy to your family. Intentionally providing false information on this application will result in denial and loss of your deposit. We do reserve the right to verify all information provided, possibly including a visit to your home. By submitting this application, you are certifying that all of your answers are true and that you have read and understand the information on our policies page.
Type your full name in the box below to show you understand and agree to this:

Please double check before submitting that your e-mail address is correct
and you have filled out the application completely. THANKS!