Any information you submit is insecure and could be observed by a third party while in transit. If you are submitting information you would like to keep private, it would be safer for you to cancel the submission. An alternative to this form is to contact us for an email form. Thank you. Name: Street Address: City: State/Province: Zip/Postal Code: Country: Phone: E-Mail: 1. Have you ever owned an Australian Cattle Dog? Yes No 2. Why have you decided to get an ACD? 3. Are you interested in the breed as a: Companion Ranch Work Herding Trials Obedience Conformation Agility Flyball 4. Are you interested in a puppy of a particular sex or color? If so why? 5. Are there children at home: Yes If so, what are their ages: No 6. Do you: Own Rent If you rent do you have permission to have a dog on the premises? Yes     No   N/A 7. Does the property have a fenced yard, kennel area? Yes No 8. Will the dog be kept: Indoors Outdoors Where would it sleep? 9. If you are not planning on showing/breeding your dog, are you willing to sign an agreement that your ACD will be spayed/neutered? Yes No