Hit N Heel Questionnaire
Litter's born in April 2005

LITTER 1: CH SO-LO HARD WORKING MAN X CH HIT N HEEL KEWL SINNER PT Litter Born April 18, 2005 click here to see pups
LITTER 2: CH SO-LO HARD WORKING MAN X HIT N HEEL KEWL N TWISTED Litter Born April 18, 2005 click here to see pups

Please indicate if you have a preference for a specific litter
NO PREFERENCE   FIRST CHOICE LITTER 1 FIRST CHOICE LITTER 2

Please complete and submit this form in full. This will help us in doing our best to provide you with a puppy that will be a potential match for you and your lifestyle.  We have found that having these questions presented first at your leisure, help everyone involved in answering questions more completely.

If you would prefer a form to fill print and fill out, please feel free to email us and ask for one.

Name:            E-Mail address:

Address:        Phone Number: 

City:        State:          Zip Code:

1.  Have you ever owned an Australian Cattle Dog?  Yes       No
    

2. Why did you decide to inquire about acquiring an Australian Cattle Dog ?    
   
    

3. Do you prefer a  Male    or Female    or No Preference
    

4. Is there a reason why you have a preference?  
   
    

5. Do you plan on participating in any of the following activities with your Australian Cattle Dog? (check any/all that apply)
   Conformation          Obedience         Stockdog trials            Agility           Tracking  
   Flyball             Breeding           Service/Therapy dog work              Ranchdog work
   
   Other please note: 
    

6. If you do not plan on breeding or showing your Australian Cattle Dog, will have your Australian Cattle Dog neutered?
       Yes              No
    

7. Please list any other pets you have at this time:
   
    

8. Do you have livestock at home?    Yes            No
   If you checked yes, what type?
   
    

9. If you have children, please list their ages:
   
    

10. Is your yard fenced:          Yes              No  
    If it is not, what are your plans on keeping your Australian Cattle Dog contained:  
     

11. Have you spoken with any other Australian Cattle Dog breeders?    Yes            No  
    If yes, please list their names:    
     

12. If yes, are you on any waiting lists?        Yes                        No
     

13. If you were referred to us, please list those individuals so we may thank them:
    
     

14. Please list 2 references (veterinarian, person who you might have doggy contact with, dog trainer etc.)
    Reference 1             Reference 2 
    
     

Please feel free to include any comments that may help us to find you a potential match: