Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Do you live in a house/ townhouse/ apartment/ others? *

House

Townhouse

apartment

Others

Rental or Own? *

Rent

Own

Do you have front and back secure fence?

Yes

No

Do you have backyard? Please attach photos via email or SMS

Yes

No

Are you Permanent residents or citizen in Australia? *

Yes

No

Are all the family members aware of this application? *

Yes

No

Have you ever had to give up a pet? *

Yes

No

Do you understand that all my puppies will present vasectomy or tubal ligation before they go? Also, new family have to desex their puppy when they are old enough.

Yes

No

What gender are you interested in?

Boy

Girl

No preference

What colour are you interested in?

Red

Black and Tan

Cream

Seasame

No preference

What age of Shiba are you and your family consider?

Baby puppy (9-10weeks old)

Minor Puppy (5 to 12 months old)

Adult (1+ years old)

Do you understand Shibas shed a lot?

Yes

No

Have you ever met a Shiba before?

Yes

No

Have you do lots of research about Shiba?

Yes

No

Don't know

Do you know Shibas will take a lot of time to train and they are stubborn?

Yes

No

You understand the price of our Shiba is around AUD$6000-7500, depending on the parents, bloodline and awards. When we contact you and your family again and you are accept for the adopting, you will need to pay AUD$1500 as the puppy deposit. The rest of fees have to pay before the flight or pick up day. *

Yes

No