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Name:
Street Address:
City:
State/Province:
Zip/Postal Code:
Country:
Phone:
E-Mail:

Have you ever owned an Australian Cattle Dog? Yes No
Why have you decided to get an ACD?
Are you interested in the breed as a: Companion Ranch Work Herding Trials Obedience Conformation Agility Flyball
Are you interested in a puppy of a particular sex or color? If so why?
What test results do you require? Do you want a PRA A or B or either? please mention other health aspects important to you..
Depending on your requirements you may have to go on a waiting list, are you prepared to do so? Yes No
Does the property have a fenced yard, kennel area? Yes No
Please list dogs or animals living with you now.
If you were referred to us, please let us know so that we may send them a note of appreciation.
To submit this application to us click on the submit button:
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