Puppy Application


e-mail :

Phone Numbers 

Do you own or rent your home?                   

what type of home do you live in?

Number of people in the home                   

Do you have any children living in the home?

If so, what ages are they?                                            

Do you currently have any pets?                                        

If so, please tell me about them.

Have you owned any pets in the past? 


If so, what happened to them?

Please provide the name, address, and phone number of your vet.

Why are you interested in an Aussie puppy?

Where will you be keeping your new puppy?

Please provide personal references

1.  Name


   Phone numbers

2.  Name


   Phone numbers

3.  Name


   Phone numbers

yes there are children
no children
I do not own any pets
yes, I do have pets
yes, I have owned pets
no, I have never owned a pet
fenced yardinvisible fencecrateloose in house