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Southern Cross Potential Puppy Owner Questionnaire Please fully complete this questionnaire and click the submit button below.There is a section at the end of this questionnaire should you want to include any additional information.This application is just a beginning step in the interview process.All information will be confidential and used only by the Breeder/Owners of this litter.Thank you for your cooperation and interest. Please complete the entire form below.

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    • Afghanistan
    • Albania
    • Algeria
    • American Samoa
    • Andorra
    • Angola
    • Anguilla
    • Antigua and Barbuda
    • Argentina
    • Armenia
    • Aruba
    • Australia
    • Austria
    • Azerbaijan
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    • Bahrain
    • Bangladesh
    • Barbados
    • Belarus
    • Belgium
    • Belize
    • Benin
    • Bermuda
    • Bhutan
    • Bolivia
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    • Brazil
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    • Burundi
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    • Cameroon
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    • Central African Republic
    • Chad
    • Chile
    • China
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    • Colombia
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    • Croatia
    • Cuba
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    • Cyprus
    • Czech Republic
    • Democratic Republic of the Congo
    • Denmark
    • Djibouti
    • Dominica
    • Dominican Republic
    • Ecuador
    • Egypt
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    • Equatorial Guinea
    • Eritrea
    • Estonia
    • Ethiopia
    • Falkland Islands
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    • Gibraltar
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    • Lesotho
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    • Lithuania
    • Luxembourg
    • Macau
    • Macedonia
    • Madagascar
    • Malawi
    • Malaysia
    • Maldives
    • Mali
    • Malta
    • Marshall Islands
    • Martinique
    • Mauritania
    • Mauritius
    • Mayotte
    • Mexico
    • Micronesia
    • Moldova
    • Monaco
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    • Montenegro
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    • Morocco
    • Mozambique
    • Myanmar
    • Nagorno-Karabakh
    • Namibia
    • Nauru
    • Nepal
    • Netherlands
    • Netherlands Antilles
    • New Caledonia
    • New Zealand
    • Nicaragua
    • Niger
    • Nigeria
    • Niue
    • Norfolk Island
    • Turkish Republic of Northern Cyprus
    • Northern Mariana
    • Norway
    • Oman
    • Pakistan
    • Palau
    • Palestine
    • Panama
    • Papua New Guinea
    • Paraguay
    • Peru
    • Philippines
    • Pitcairn Islands
    • Poland
    • Portugal
    • Puerto Rico
    • Qatar
    • Republic of the Congo
    • Romania
    • Russia
    • Rwanda
    • Saint Barthelemy
    • Saint Helena
    • Saint Kitts and Nevis
    • Saint Lucia
    • Saint Martin
    • Saint Pierre and Miquelon
    • Saint Vincent and the Grenadines
    • Samoa
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    • Saudi Arabia
    • Senegal
    • Serbia
    • Seychelles
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    • Singapore
    • Slovakia
    • Slovenia
    • Solomon Islands
    • Somalia
    • Somaliland
    • South Africa
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    • Spain
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    • Sudan
    • Suriname
    • Svalbard
    • eSwatini
    • Sweden
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    • Syria
    • Taiwan
    • Tajikistan
    • Tanzania
    • Thailand
    • Timor-Leste
    • Togo
    • Tokelau
    • Tonga
    • Transnistria Pridnestrovie
    • Trinidad and Tobago
    • Tristan da Cunha
    • Tunisia
    • Turkey
    • Turkmenistan
    • Turks and Caicos Islands
    • Tuvalu
    • Uganda
    • Ukraine
    • United Arab Emirates
    • United Kingdom
    • United States
    • Uruguay
    • Uzbekistan
    • Vanuatu
    • Vatican City
    • Venezuela
    • Vietnam
    • British Virgin Islands
    • Isle of Man
    • US Virgin Islands
    • Wallis and Futuna
    • Western Sahara
    • Yemen
    • Zambia
    • Zimbabwe
    • Other
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    • Internet
    • Veterinarian
    • Dog club puppy referral
    • Another breeder
    • Other
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    • Yes
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    • Own
    • Rent
    • Lease
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    • House
    • Apartment
    • Condo
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    • Yes
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    • No Preference
    • Male
    • Female
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    By submitting this application, I am acknowledging that the information entered is true and correct. I understand that sending this application does not automatically entitle me to a dog.
    I understand that this application is just a beginning step in the interview process.

    Please review and then submit this completed questionnaire. We will contact you via Email as soon as possible regarding the availability of our Southern Cross puppies.

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