Questionnaire – Adams Ranch ACDs

Name *

First

Last

Address *

City *

State *

Zip Code *

Phone *

Email *

What made you decide to get an ACD? *

Have you ever owned an Australian Cattle Dog? (ACD) *

Yes
No

Do you prefer a male or female? *

Male
Female

Why do you have this preference? *

Do you have a color preference? *

Red
Blue
No Preference

How soon are you looking to purchase an ACD Puppy? *

Do you plan on participating in any of the following activities? (Please check any that apply) *

List other

If you are not planning on showing/breeding your dog, are you willing sign a spayed/neutered agreement? *

Yes
No

Do you intend to breed the dog? *

Yes
No

Do you currently own any other dogs? *

Yes
No

If you have dogs, how many and what breed?

If no, what is your prior exposure to dogs?

Do you currently have, or plan to have, children? *

Yes
No

If yes, please list their ages:

Type of dwelling: *

If renting, please provide name and phone number of landlord:

How long have you lived at this address? *

Do you have a fenced yard? *

Yes
No

If not, how do you plan on keeping your dog confined when you are not home?

Referred by:

Name and phone number

Veterinarian Referral:

Name and phone number

Does anyone in your household have allergies to animals? *

Yes
No

If yes, to what and how severe?

What do you expect the activity level of this breed to be: *

Couch Potato
Mildly Active
Very Active
Other

List other

Will you be attending any training classes? *

Yes
No

How long did your last pet live and what were the circumstances of its' death? *

Have you ever returned a pet to the breeder? *

Yes
No

Have you ever given a pet away? *

Yes
No

If yes, what were the circumstances?

Have you ever taken a pet to a pound or shelter? *

Yes
No

If yes, what were the circumstances?

Are you interested in showing the dog in the conformation ring? *

Yes
No

Have you ever shown a dog to its championship? *

Yes
No

Have you shown a dog to any performance titles? *

Yes
No

Do you understand the difference between a limited registration and a full registration? *

Yes
No

What reference materials have you read? *

Are you a member of any local Kennel Clubs or National Breed Clubs? Please Specify: *

Any additional Comments you want to share?