Name:
Address:
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
Address
Phone numbers
2. Name
Address
Phone numbers
3. Name
Address
Phone numbers
