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Employer
(Primary):
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Occupation:
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Average
hours worked weekly:
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Number of
adults living in household:
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Hours adults
are home daily (including yourself):
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Number of
children living in your household:
Ages:
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What type of
area do you live in?
City
Suburban
Country |
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What type of housing:
Apt.
Condo
Duplex
House
Other
(please explain, how
long you have lived here, etc.)
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If you
rent or lease, do you have permission from your landlord
to own a dog?
Yes
No
(Name and Phone number
of your landlord)
If less
than two years, please list your previous address:
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What breed
of dog have you previously owned and what happened to
them?
Were they spayed/neutered?
Yes
No
(both as appropriate) |
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Is everyone
in your household in agreement on adopting a rottweiler?
Yes
No
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Other pets
in the household -- breed, age, spayed/neutered, up to
date in vaccinations:
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What do you know about the Rottweiler as
a breed?
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Why do you
want a Rottweiler?
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How did you
hear about us, and/or who referred you to us?
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Do you have
a preference as to what sex the rottweiler is?
Yes
No
If "yes," why?
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Do you have
a fenced yard?
Yes
No
Specifically, what kind of fence and how tall:
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What member
of the family will be taking the MAJOR responsibility
for raising and taking care of this rottweiler?
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What are
your plans for this rottweiler?
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Will the
rottweiler live inside the home?
Yes
No
If "no," where live?
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Where
EXACTLY will the rottweiler sleep at night and be kept
when there is no one at home?
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Have you
ever used a crate before?
Yes
No
Do you have an objection to using a crate?
Yes
No
If yes, why?
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What are the
major activities, hobbies, or exercises you and your
family participate in most?
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Please list
your veterinarian's name/address/phone number.
Call your vet and advise them that I may be checking
on the health care of your previous/current pets.
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Please list names,
addresses and phone numbers of three personal references
that have known you for at least two years:
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Are
you currently or previously involved with any dog clubs,
Humane Societies, etc.?
Yes
No
If "yes," what club?
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Where
exactly do your dogs live?
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Any
additional comments you may have:
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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. If upon inspection we find that
information contained in this questionnaire to be false,
we retain the right to turn you down as a prospective
puppy buyer from us.
Electronic E-Signature |