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1. Have you ever owned an Australian Cattle Dog?             Yes     No

2. What made you decide to purchase an Australian Cattle Dog?
   

3. Do you prefer a male or a female?             Male     Female     No Preference

   Why?
   

4. Do you have a color prefence?             Blue     Red     No Preference

   Comments on color preference:
   

5. Do you plan on participating on any of the following activities with your ACD?
   (check all that apply)

   Conformation	Obedience	Herding	Agility
   Tracking	Flyball	Therapy	Breeding
   Family Pet	Other:

6. If you are not planning on breeding or showing, would you be willing to have your Australian Cattle Dog Spayed or Neutered?             Yes     No

7. Do you currently own any other dogs?             Yes     No

   If Yes, please list them below along with breed, age, sex and spay/neuter status:
   

8. Do you currently own any other animals (non-canine)?             Yes     No

   If Yes, please list them below:
   

9. If you currently do not own any dogs, can you tell me about your past exposure to dogs and dog ownership?

10. Do you have children?             Yes     No

    If Yes, please list their names and ages below and give me a brief idea of their exposure to dogs:
    

11. What are your plans for housing and exercising your Australian Cattle Dog?
    

12. Is your yard fenced?             Yes     No

    Please describe dogs exercise area:
    

13. On average, what do you plan to spend per year on food, veterinary care, etc.
    for your Australian Cattle Dog? $

14. How much do you expect to pay for an ACD puppy? $

15. Have you spoken with any other ACD breeders?             Yes     No

    If Yes, please list them below:
    

16. Are you currently on the waiting list for any other litters?            Yes    No

17. What are your plans for transporting this puppy/dog to you?

18. Were you referred to me by anybody in particular?            Yes    No

    If Yes, please list them below:
    

19. Are you at all interested in being contacted about Rescue Dogs (note that clicking on this link will pen a new browser window for you and you will thus not lose your questionnaire answers if you want to find out more about rescue before answering this question) or older dogs needing placement if we should come across a dog that we feel would suit your needs?             Yes     No

    
    
    

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    Please list several references
    (veterinarian, person active in dogs or close acquaintance preferred).

    Kindly note their relationship to you in the text box with their contact information

    Please include a phone number for each reference (and e-mail address if possible):

    Reference 1:
    

    Reference 2:
    

    Reference 3:
    

    Reference 4: