APPLICATION FOR A PUPPY

Rutlands Australian Cobberdogs Facts & Breed Info.

APPLICATION FORM TO APPLY FOR A PUPPY

* Indicates required field

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Phone Number *

DATE with MONTH in full as per instructions *

Countries have different formats for writing dates so please write the month is full. e,g, 30th March 2025.

PURPOSE OF PUPPY *

Companion Therapy at home Therapy Visitations School Dog, Clinic Dog Other

SIZE PREFERRED *

STANDARD (Large) MEDIUM MINIATURE (Smallest)

GENDER *

EITHER (Nature more important) MALE FEMALE

COLOURS YOU PREFER. COLOURS YOU WILL NOT ACCEPT. *

ANY OTHER PETS? PLEASE DESCRIBE *

SECURELY FENCED *

YES NOT YET WILL BE IN TIME FOR PUPPY

TIME FRAME REQUIRED IF POSSIBLE *

ANYTHING ELSE YOU'D LIKE TO TELL US? *

GETTING TO KNOW YOU *

BY PHONE BY EMAIL

IS YOUR PUPPY FOR BREEDING? *

NO YES

PUPPIES FOR BREEDING ARE MUCH MORE EXPENSIVE. EMAIL US FOR PARTICULARS.

IF YOUR PUPPY IS NOT FOR BREEDING ARE YOU WILLING TO SIGN AN AGREEMENT TO DESEX? *

YES NO

ARE YOU READY TO BE INVOICED FOR NON REFUNDABLE DEPOSIT OF $500? *

YES

DO YOU AGREE THAT TYPING YOUR NAME MAKES THIS A LEGALLY BINDING AGREEMENT? *

YES

TYPE YOUR LEGAL NAME HERE *

You may Upload an image File here *

Max file size: 20MB

Submit