~  ALL FIELDS ARE REQUIRED!  WE WILL NOT REPLY TO FORMS NOT FULLY COMPLETED  ~

Contact Information

Your Name:        

E-Mail Address:  

Mailing Address:

City: Province/State: Postal/Zip Code:

Home Information

Do you own your home? Yes     No

If you are renting do you have the permission of your landlord to keep a dog?  Yes    No

Where is your home located (urban, suburban, rural)?

Do you have a fully fenced yard, or a suitable enclosure for the dog?  Yes    No  

If you answered Yes to the previous question please describe the size and type of enclosure:

If you answered No to the above question please tell us how you intend to ensure that the dog
is kept safe and receives an adequate amount of exercise?

Will the dog be kept Choose inside outside both     

Please elaborate on the above choice:

Where will the dog spend its nights?

How many adults are in your family, and are they all in agreement with the decision to get a dog?

Do you have children, and if so what are their ages?

Who will be the primary caregiver for this dog?

Do you have reservations regarding our Spay/Neuter requirements? Yes     No

If you answered Yes please elaborate on your reasons:

Have you used, or will you use, a crate to confine your dog? Yes     No

Please elaborate on your answer to the question above:

Approximately how many hours per day will the dog be left alone?

What provisions will you make for when the dog is alone during the day?

What provisions will you make for the care of this dog in the event of your illness or death?

What would you do with this dog if it became necessary for you to move?

Have you previously owned a dog?  Yes     No

If you answered Yes please tell us about him/her/them:

If you answered No please tell us why you have now made the decision to get a dog:

Do you have other animals in your home now?  Yes     No

If so please tell us about them:

Would you be willing to enroll in Obedience classes to assist you with training your dog?

Why have you decided that an Aussie is the breed for you?

Do you intend to participate in any of these dog sports (please check all that apply):

Please tell us about any other activities you will be sharing with this dog (hiking, camping,  X country skiing, etc.)

Please give us the names and contact information (telephone number or e-mail address) of three references
one of whom we would prefer to be your veterinarian:
Reference 1:
Reference 2:
Reference 3:

Please use the space below to tell us what you are looking for in an Aussie (age, sex, colour, temperament, etc.) and for any additional information you might feel would be helpful to us in determining if you would be a suitable parent for a Copperkit kid...