Fort Valley, Georgia

Puppy Questionnaire

Home Phone:
Work Phone: 

1. Do you own or rent your home?
2. How long have you lived at this address?
3. How large is your yard/or how many acres?
4. Do you have a fenced yard?
5. If so, what type of fencing?
6. If you do not have fencing, how will you handle the puppies exercise and toilet duties?
7. How many adults and children in household?
8. Ages of children?
9. Do you own other dogs?
10. If yes, describe breed, sex, and age:
11. If you own other dog or cats are they neutered or spayed?
12. If you own dogs and/or cats please give the name, address, and phone number of your veterinarian:
13. How many dogs have you owned in the last ten years?
14. If you have owned dogs in the last ten years that are not presently living with you, tell us what happened to the dog(s) and be specific:
15. Have you owned an Australian Shepherd before?
16. If so, provide, name and contact information of the breeder you purchased your puppy from.
17. What Dog Clubs are you Affiliated With?  Provide Name of Club or state None
18. Why did you choose this breed?
19. What is your color preference?
(Control Click on each color)
20. Do you want a Male or Female?
21. Which Litter are you interested in?
22. Will the puppy reside in the house?
23. If you work how will the puppy spend its days?
24. How will the puppy spend the night? Crated or uncrated?
25. How many hours on average will the dog spend alone per day?
26. List all plans for this dog: Pet,  Herding, Obedience, Conformation, Agility, Breeding, Guard, Other: 
27. Have you put any titles on any of your previous dog(s)?  If yes, list the titles and registered name of the dog(s): 
28. Names and contact information (Email, phone number) from breeders you have purchased your previous dogs from.
 29. Please provide any additional comments you would like to make:

All companion puppies are sold on strict spay/neuter contracts!

All show/performance prospects (if left Intact) are sold on co-ownership!


Due to bad people in this world our form has been hit by some stupid computer spam "thing" so, unfortunately,
 we have to add one of those irritating CAPTCHA to trick the computer's that hack our form.  A CAPTCHA is those squiggly
letters/numbers that you have to type in a box.  As soon as I figure out how to write the code "correctly" you'll be forced to do one
before you can submit the form.  I apologize in advance for the inconvenience!!



Copyright 2000-2014 NiteStar Australian Shepherds. All rights reserved.
Revised: June 06, 2016 .