address:
city, state and zip code:
phone number:
best time to reach you at this number:
Your email:
How long at this address?:
What are your plans for your new puppy/rescue? Conformation showing Obedience Tracking/search and rescue Breeding Schutzhund/protection work Agility Herding Family pet/companion animal
If you are buying a show prospect or aquiring a puppy to attain working titles, please tell us about your experience with titling a dog.:
If you are looking for a breeding prospect,please explain your experience and goals as a rottweiler breeder.:
What health certifications do you feel are important or necessary prior to breeding?:
What is you preference? Male Female No preference
Have you educated yourself on the subject of Breed Specific Legislation? Yes No
Have you owned a rottweiler before? What are their ages? Where are they now?:
Other animals living with you, what kind, how many?:
Do you have children living with you? What are their ages?:
What kind of home do you live in, condo, house, or apartment? Do you own or rent your home?:
Do you have a fenced yard? Please discribe in detail.:
Have you ever given up a dog or cat to an animal shelter? Please explain.:
Who will be the main caregiver for you new puppy? Where will new rottweiler spend his day? His night? How many hours will he be left alone each day?:
Your veterinarian: name, address, phone number:
Please give two personal references: name, address, phone number
Please give us any additional information that you may feel will help us choose the appropriate dog for you.:
