Please copy and paste the questions below into an e-mail and send it to

                  We will eventually have a better system for our questionnaire. If you have made it to this page, then we know you are serious about adding an
Aussie to your life. Please consider this questionnaire your application for a puppy. Completing it supplies us with valuable information, which will help us
make a smart choice for the best possible puppy/dog for your family.

After reviewing your questionnaire, if we have any further questions we will contact you. Please feel free to contact us any time with any further questions
you may have about us. Selling puppies is not why we are involved in the Australian Shepherd world. We are simply involved because of “the love of the
breed”. Our puppies are carefully raised and socialized. We are working to breed sound healthy dogs that conform to the AKC breed standard. Our wish is to
find loving lifelong homes for the dogs we can no longer keep.

Please copy the questions below into an e-mail and answer them honestly.  


Street Address:

City, State, Zip:

Mailing Address (if different):

City, State, Zip:

Daytime Phone:
Evening Phone:


Website, if any:

Will this be your first Australian Shepherd?

When did you decide that an Australian Shepherd was for you and why?

Have you read any books on the Australian Shepherd or researched any information about this breed?

Have you considered any other breed? If yes, what?

List other pets or animals you have. (Species, breed, age, sex, spayed/neutered/intact)

Have you had pets in the past, which you no longer have? If yes, how did you lose them?

Have you ever bred a litter?

Have you ever surrendered an animal to an animal shelter or rescue organization?

List all household members. If children are included in your family, please list age and gender of each.

Are you aware of any allergies to animals of anyone in your household?

Who will have primary responsibility for the care of the puppy?

Please tell us something about yourself, your family and your lifestyle.

Do you rent or own your housing?
Rent           Own

What type of housing do you live in?
Single Family       Duplex       Apartment       Other

If rent, does your lease allow dogs or does your landlord know of your impending addition?

Do you have a fenced yard where your puppy will be supervised, if not, what are your plans for exercising and for your puppy to go potty safely?

How and where will your puppy spend his/her day?

How and where will your puppy spend his/her nights?

Describe the ideal temperament of an Australian Shepherd who would fit perfectly into your household.

List all activities you might be interested in pursuing with your puppy. (Select all that apply)
Household companion                                    Therapy
Obedience                                                        Flyball
Agility                                                             Conformation shows    
Tracking                                                         Jr Showmanship
Herding                                                           Breeding
Hiking                                                             4-H

For those interested in an Australian Shepherd to show in Conformation:
Are you aware of the expense and time involved with showing a dog?

For those interested in an Australian Shepherd for Performance:
Please tell us a little about your training methods and experience.

For those interested in an Australian Shepherd as a companion:

How do you plan on exercising your puppy, both mentally and physically?

If you are purchasing for performance or a companion only, how do you feel about a spay/neuter contract?

Where do you plan on taking Obedience classes with your puppy?

What is your main goal with this puppy?

What training methods will you use to handle potential problems such as chewing, barking, and house breaking?

Do you prefer a puppy or an older dog?

Do you have a color or male/female preference?

Are you or have you been a member of any dog clubs or organizations? Please list.

Have you ever been suspended by AKC?

Personal References:

Reference #1   Name:

Phone or Email:

Reference #2   Name:

        Phone or Email:

What is the name of the Veterinarian you currently go to?



Phone #:

May we contact your Vet as a reference?

Yes       No

Any Other Comments?

Thank you for considering a SummeReane Australian Shepherd as a part of your new family, we will contact you
either by phone or e-mail.
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