If a question does not apply to you then please put N/A in that space. Print out this application, then, please respond to all questions. When completed, mail to:
| Personal Information: | ||
| Name: | Age: | Phone #: |
| E-mail address: | ||
| Spouse Name: | Age: | |
| Address: | City/State/Zip: | |
| How long have you lived at this address? |
If less than two years, please list your previous address: |
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| Your employer: | ||
| Spouse's Employer: | ||
| Number of children: | Their ages: | |
| Is everyone in the home in agreement on a Rottweiler? |
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| If no, who is not and why? | ||
| Please indicate which best describes your current living situation: | House Condo Apartment Mobile Home | |
| Do you? Rent Own Live w/Parents | ||
| If you rent, name & phone number of Landlord: (required) | ||
| Besides your immediate family, are there others residing in your home? Yes No | ||
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Names: _________________________________________________________ |
Ages: _______________________ | |
| Does your home have a yard? Yes No | Is there a fence? Yes No | |
| What type of fence and how tall? | ||
| If you do not have a fence to you plan on putting one up? Yes No | ||
| If yes, when and what type of fence? | ||
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| Adoption Information: | ||
| Is someone home during the day? Yes No |
If not, where will the dog stay while you are gone? |
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| Where will the dog be kept most of the time? Inside Outside Other | ||
| Please define "Other": | ||
| If kept outside, how will you insure the dog stays home? | ||
| Do you have a homeowners or renters insurance policy? | Name of insurance company: | |
| Do you own a Dog Crate? Yes No | If so, what type and size is the crate? | |
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If you do not own a crate are you willing to buy one and crate train the rescue? Yes No |
If no, please explain why? | |
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Will you take your dog to obedience class? Yes No |
If you are not willing to take the rescue to obedience class, |
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| Have you ever owned a Rottweiler? Yes No | ||
| Where is that Rottweiler now? | ||
| Is there a Rottweiler on the website you're interested in? Yes No |
If so, which one? |
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| Do you prefer a male or female Rottweiler? Male Female | ||
| Why that sex? | ||
| What age range are you interested in? | ||
| How did you choose a Rottweiler? | ||
| Will the Rottweiler be used as a guard dog? Yes No | ||
| If yes, please explain: | ||
| What other activities do you plan to do with your Rottweiler? | ||
| How many years do you plan to keep the dog? | ||
| Under what circumstances would you feel it necessary to get rid of your dog? | ||
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| Other Pet Information: | ||
| Do you have other pets? Yes No | ||
| Please list the other types of pets you have along with their age, sex and if they are spayed or neutered: | ||
| Are your other pets current on all vaccinations? Yes No | ||
| Are your current pets spayed/neutered? | ||
| If no, please explain: | ||
| Veterinarian's name & Phone Number: | ||
| If applicable, approximate date of your current pet's last office visit: | ||
| List the pets have you owned in the past ten years and what happened to them: (use another sheet if necessary) | ||
| How did you hear about Alaska Rottweiler Rescue? | ||
| List any Humane Societies, Organizations, Breed or Training Clubs you are associated with: | ||
| We will attempt to provide you with an honest evaluation of temperament on any dog we have to place. Do you realize that often times the complete history of a Rottweiler may not be known and you may encounter some behavioral problems? {i.e. housebreaking, jumping up, digging, barking, etc..} Yes No | ||
| Are you willing to work with us on correcting these problems? Yes No | ||
| If no, please explain which problems you would not be willing to work on: | ||
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Please provide the name, address and phone number of three references: Reference # 1: Reference # 2: Reference # 3: |
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| Adopter also understands that the rescue will be spayed or neutered, micro-chipped and current on shots when they receive the rescue: Yes No | ||
I certify that the information provided on this form is true
& correct. I am also financially and physically able to care
for this animal. I understand that proper food and veterinarian
care can be costly and I am able to meet these requirements. Home
checks are made on a random basis following or prior to adoption.
If upon inspection we find that information contained in this
application to be false, we retain the right to turn down or remove
the animal from your premises without a refund of moneys paid.
Signature: ____________________ Date: __________________