Name: __________________________________________
Occupation: ______________________________________
Names of others in home, if children please list ages:
Your address:_______________________________
__________________________________________
City: ______________________________________
State: ________________ Zip: _________________
Your Email: ________________________________
Home Phone:__________ Work Phone:__________ Fax:__________
How did you find us?
_____American Kennel Club
_____Australian Cattle Dog Club of America Inc.
_____Internet Which Site?
_____Cattledog.com
_____ACDCA Referral
_____LnRRigB.com
_____Wallaby Kennels
Other: ___________________________________________________
Do you currently own any other dogs or other animals? __________If yes, please list them below along with breed age, sex and spray/neuter status:
If you currently do not own any dogs, please tell me about your past exposure to dogs, dog ownership and cattle dogs?
What made you decide to purchase an Australian Cattle Dog?
Do you prefer male or female?__________Why?
Do you have a color preference? _______________
Do you plan on participating on any of the following activities with your ACD?
_____Breeding _____Conformation _____Agility _____Herding _____Obedience _____Flyball _____Serach and Rescue _____Therapy
_____Tracking _____Other ____________________________
If you are not planning on breeding or showing would you be willing to have your ACD spayed or neutered?
Where will pup be during the day?
Where will pup be during the night?
What are your plans for exercising your ACD?
Please list at least two references and their relationship to you i.e. veterinarian, dog trainer, friend etc. with email and or evening phone number, Vet should be work phone number
Name: _________________________Email:____________________ Phone:______________
Name: _________________________Email:____________________ Phone:______________
Name: _________________________Email:____________________ Phone:______________