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First Name
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Family Name
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Suburb
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State
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Home Phone (incl. area code)
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Mobile Phone
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Email Address
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Choice of puppy
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Male
Female
No Preference
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Choice of colour
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Red
Brindle
Fawn
No Preference
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Purpose of Bullmastiff
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Breed
Show
Family companion
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List the reasons why you want a Bullmastiff
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What do you know about the Bullmastiff?
(ie temperament, origins of the breed, breed standard etc)
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Have you owned large breed dog(s) before?
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Yes
No
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If yes, what breed(s)?
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Do you currently own other dogs?
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Yes
No
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If yes, what breed(s)?
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Are they neutered?
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Yes
No
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If no, why not?
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Where do you intend to keep your dog while you are at work?
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What do you intend to do with your dog when you are on holidays?
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Do you have stairs anywhere in your home?
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Yes
No
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If yes, please state where and how many.
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What is the surface of the stairs? i.e. carpet, concrete, timber etc.
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What type of fences do you have? (i.e. chainlink, timber, rural, colourbond etc)
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How high are the fences?
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Number of adults
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Number of teenagers
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Number of children under 12
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Where did you hear about TiaraRebel Bullmastiffs?
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