Applicant Information
Full Name
Address
City, State Zip
How long at this address?
Year of Birth
Home Phone
Work Phone
Cell Phone
Email
How Long?
Employer?
Occupation
Are you a student?
Where? Grad date?
References  (References cannot be family members or live with you)
Reference Name
Relationship to you?
Phone
Reference Name
Relationship to you?
Phone
Co- Applicant Information
Relationship to the applicant?
Full Name
Address
City, State Zip
How long at this address?
Year of Birth
Home Phone
Work Phone
Cell Phone
Email
How Long?
Employer?
Occupation
Are you a student?
Where? Grad date?
Do you?
How will you keep
the dog confined to
your property?
Please list the names of ALL
adults living in your house
Please list the names and ages
of ALL children in your home
(include grandchildren and/or
children that visit often)
Yes
Does anyone in your home have pet allergies?
No
If yes, Please explain
Yes
Has anyone in your home been convicted of a felony?
No
If yes, Please explain
Why do you want a
Rottweiler?
Do you want?
male
Under what circumstances would
you not keep your dog?
Female
Who will be responsible for the exercise,
grooming, health care, and feeding of the dog?
How much money do you think you will spend annually for the care
of your dog? (ie: food, medical, toys, boarding, grooming, etc...)
Where will your dog be kept during the day?
Where will your dog be kept during the night?
If the dog will live outside, what type of
shelter is available?
How will you exercise your dog?
How much time are you willing to devote to daily exercising your dog?
How will you handle barking,
chewing, scratching, digging and
other destruction?
Yes
No
Do you plan on enrolling your dog in obedience classes?
Why or why not?
Tell me about all the pets you have had in the past 10 years:
Name
Name
Cat
 Other
Cat
 Other
 Dog
Dog
Breed
Breed
Sex
Sex
Age
Age
Yes
Yes
No
No
 Spayed/Neutered?
Spayed/Neutered?
Both
Both
 In
In
 Housed:
 Out
Housed:
 Out
Where is this
pet now?
Where is this
pet now?
Name
Name
Cat
 Other
Cat
 Other
 Dog
Dog
Breed
Breed
Sex
Sex
Age
Age
Yes
Yes
No
No
 Spayed/Neutered?
Spayed/Neutered?
Both
Both
 In
In
 Housed:
 Out
Housed:
 Out
Where is this
pet now?
Where is this
pet now?
Name
Name
Cat
 Other
Cat
 Other
 Dog
Dog
Breed
Breed
Sex
Sex
Age
Age
Yes
Yes
No
No
 Spayed/Neutered?
Spayed/Neutered?
Both
Both
 In
In
 Housed:
 Out
Housed:
 Out
Where is this
pet now?
Where is this
pet now?
What will you feed your Rottweiler as a puppy? As an adult?
Yes
No
Have you ever had to "get rid" of a pet?
If yes, please explain
Veterinarian Name,
Address, and Phone
Serena
Scribbles
Asia
Puppies
Riley
Asia
Grimm
Keebler
Phoenix
Puppy Application
Phoenix
Puppies
I receive many requests for Rottweiler puppies and I'm are looking for only the best of the
for personal information.  Especially for a breed like a Rottweiler, it is important to make
sure that the people who get them have only good intentions of making these pups
ambassadors for the breed.  Please fill the entire form out- missing information will result
in either a delay in the application process or denial of your application.