Breeder Membership Application - Australian Labradoodle Association

Applicant's name(Required)

Applicant’s mentor(Required)

Date of application(Required)

Proposed kennel name(Required)

Local council(Required)

Physical address(Required)

Street Address Address Line 2 Suburb State Postcode Country

Is your postal address different from your physical address?(Required)

Yes

No

Postal address(Required)

Street Address Address Line 2 Suburb State Postcode Country

Home phone

Mobile

Email(Required)

Do you have a council breeder’s permit?(Required)

Yes

No

Council breeder’s permit number(Required)

Do you have an ABN?(Required)

Yes

No

ABN(Required)

Is your business registered?(Required)

Yes

No

Business registration - name(Required)

Do you have public liability insurance?(Required)

Yes

No

Public liability insurance value(Required)

Do you have a website?(Required)

Yes

No

Website address(Required)

Do you have a state breeder number?(Required)

Yes

No

(BIN PER DAC MB)

State breeder number(Required)

General

Are you currently actively breeding Labradoodles and/or Australian Labradoodles? If yes please give details.(Required)

What dogs, if any, do you currently have in your breeding program? (Please include origin breeds eg Poodle/Labrador/Cocker Spaniel/Spoodle, as well as Labradoodles). Are they ALA registered?(Required)

How can you contribute to the ALA to promote the breed?(Required)

Experience & Background

Have you previously been involved in the breeding of animals, in particular dogs? Please specify(Required)

Are you a member of an animal welfare group or canine association? Please specify(Required)

Have you been denied membership or suspended/expelled from an animal/dog breeding association? Please specify(Required)

Have you been charged with any offences related to animal cruelty/neglect?(Required)

State & Local Council Breeding Legislation/Requirements

The ALA requires members to breed according to their states regulations in regards to dog breeding. Please list some of these requirements from your state legislation and please include web page links if applicable(Required)

What are your local council requirements for breeding dogs in your area? (please attach links below)(Required)

Local council requirements(Required)

Drop files here or

Max. file size: 10 MB, Max. files: 10.

Certificate from online breeder training(Required)

Max. file size: 10 MB.

http://agriculture.vic.gov.au/pets/community-and-education/breeder-training-course

Letter of introduction from applicant(Required)

Max. file size: 5 MB.

Letter of introduction from nominator and mentor(Required)

Max. file size: 10 MB.

Membership application proposer & seconder signatures(Required)

Max. file size: 10 MB.

If you haven't already downloaded the document, click here to download.

You will need to get a witness to witness you signing this form and sign it themselves below (you can use your mouse on the computer or your finger on your phone).

Applicant’s statement of intent:(Required)

I hereby acknowledge that this is a true and accurate account of my aspirations for the Australian Labradoodle breeding program I intend to establish and manage.

This information is submitted in support of my application for membership with the Australian Labradoodle Association (ALA) and I consent to it being shared with my mentor/s and the membership as part of the application process.

I acknowledge that I have read the ALA’s Code of Ethics, Rules and Regulations and Policies as currently published on the ALA website and agree to abide by these and all future amendments should my membership be granted.

You must tick all of these to submit form.

Applicant’s signature(Required)

Applicant signature date(Required)

Witness’s signature(Required)

Witness signature date(Required)

Witness’s name(Required)

Witness’s address(Required)

Street Address Suburb State Postcode Country

Name

This field is for validation purposes and should be left unchanged.