< Francois van Rooyen, South African knife maker. Simply Made knives for hunting, field and wildlife adventures.
All items marked with an asterisk must be completed to process the form -
but you are strongly advised to fill in all information as this will best enable us
to assess your suitability for adoption of a Vaalthorn Australian Shepherd.
Name:*
Address:
City:
State or Province:
Zip Code or Postal Code:
Home Phone:*
CellPhone:
Email:*
Occupation:
Do you own or rent your home?
How long have you lived at this address?
How large is your yard/or how many acres?
Do you have a fenced yard?
If so, what type of fencing?
If you do not have fencing, how will you handle the puppies exercise and toilet duties?
How many adults and children in household?
Ages of children?
Do you own other dogs?
.If yes, describe breed, sex, and age:
.If you own other dog(s) are they neutered or spayed?
If you own cats are they declawed?
If you own a dog(s) and/or cat(s) please give the name, address, and phone number of your veterinarian.
Have you owned an Australian Shepherd before?
.Why did you choose this breed?
.How many dogs have you owned in the last ten years?
If you have owned dogs in the last ten years that are not presently living with you, what happened to dog(s) and be specific.
Will the puppy reside in the house?
If you work how will the puppy spend its days?
How will the puppy spend the night? Crated or uncrated?
How many hours on the average will the dog spend alone per day?
List all plans for this dog: Pet, Guard, Herding, Obedience, Breeding, Conformation, Agility, Other.
Please provide any additional comments you would like to make.  


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