We want to know you better.....

Puppy or Dog Request Form:
Please print off this page, read it thoroughly and mail it to me. Thank you!

Mail to:
Julie Michaels - River Runs Australian Shepherd Kennel
111 Ream Road, Winter Haven, FL 33880

NAME:
ADDRESS:
CITY:			STATE / ZIP:
HOME PHONE:			CELL PHONE:
EMAIL:
Have you or your family ever owned an Aussie before? If no, are you aware of the exercise, grooming and training requirements of this breed?					YES		NO
Do you or your family currently own an Aussie?					YES		NO
What facilities do you have for your new Aussie?		KENNEL		FENCED YARD		OTHER:
Are you prepared to commit to a minimum of basic obedience training under the supervision of a professional?					YES		NO
If you have other dogs, briefly tell us about them (breed, sex, age and whether spayed/neutered)?
If you have children, what are their ages?
If you own a dog or other pet/s, below, please give the name, address, and phone number of your veterinarian so that we may contact them for a reference.

VET INFORMATION:

Name

Address

City

State/Zip

Phone ( )

Check Preference (please check your 1st and 2nd preference)

COLOR:
	RED MERLE	BLUE MERLE	RED TRI	BLACK TRI	RED BI	BLACK BI	NO PREF.

SEX	MALE	FEMALE	NO PREF.	EYE COLOR PREFERENCE	1 BLUE EYE	2 BLUE EYES	NO PREF.

What areas of interest would you like to pursue with your Aussie? (check all that apply)

WORKING	STOCK	OBEDIENCE	CONFORMATION	AGILITY	4-H PROJECT	WATCH DOG	TRICK DOG	COMPANION

BREEDING	OTHER

In your own words, what are your plans for this puppy or dog?
List any information you think will be helpful to me in helping to choose the right puppy or dog for you and your family:
Mail to: Julie Michaels - River Runs Australian Shepherd Kennel 111 Ream Road, Winter Haven, FL 33880	Email: info@riverrunskennels.com Phone: 111-222-3333 Cell: 222-444-4444

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