The following form is designed to help us determine if one of our Aussies is the right choice for you and which puppy would be best suited to your situation. It also assists in getting acquainted.  Please feel free to respond with answers as long or as short as you wish. If you have questions for us or we can provide more information, please do not hesitate to contact us. 

Please Print this questionnaire fill it out and mail to:  Alicia Gatz 14108 E. 223^rd St. Peculiar, Missouri 64078 or copy and paste it into email and send it to aliciakaygatz@yahoo.com

Name:                                                                                                                                                                          

Mailing and physical address:                                                                                                                                                                       

Email address:                                                                          Web address:                                                           

Telephone:                                                                                            Cell:                                                        

Are you looking for:  pet_____* performance_____show_____breeding____agility_____herding____ 4-H ____

What is your color preference: Red merle___________ blue merle_________ black tri_______red tri______   

Do you prefer:  male___ female___

Will you have your Aussie spayed or neutered: yes____ no____

If you are interested in breeding this dog, what are your reasons for breeding:_______________________________________________________________________________

Registration applications for all Australian Shepherds placed as “pets” will be marked as “non-breeding”

Have you had Australian Shepherds before?  Yes_______No__________

Do you have other family members? Yes ________ No_________

            Ages of humans: ___  ___  ___  ___  ___

            Types and ages of canine or other animals: _____________________________________

  How did you find Circle G Gang Aussies (ie web, reference, breeders directory)__________________________

Are you in contact with any other Aussie breeder concerning purchase of a puppy:     Yes____ No____

While we love Aussies, they have characteristics and requirements that some may find difficult to manage.  Please read and initial the following:

  “The Australian Shepherd is a medium size, active breed which sheds its coat biannually.  They are curious and need to remain active and involved with their family in order to maintain a solid temperament. Aussies will show guarding behavior, including barking to alert for changes in the environment.  Because they are a herding breed, they will chase and nip at the heels of young children as well as moving objects.  Prolonged confinement and neglect can produce aggression in this breed.  They are a sensitive dog and do not respond well to hard handling.  Positive reinforcement methods, regular training and socialization as well as a structured, loving home life are best for the Australian Shepherd”                                                  Please initial __________

We thank you for taking the time to fill in this questionnaire.