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First Name:
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Last Name:
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Email address:
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Age:
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Spouse’s Name:
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Spouse’s Age:
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Address:
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City:
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State:
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Zip:
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Phone:
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# of Kids:
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Ages:
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Is everyone in your household in agreement on adopting a
Rottweiler?
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How long have you lived at this address?
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If less than two years, list your previous address:
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Please indicate what best describes your current living situation:
Condo Mobile
Home Apartment House
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Do you…
Rent Own
Live With
Parents
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If you rent, name and number of landlord:
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What type of environment? City
Suburban Country
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Does your home have a yard? Yes
No
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Is there a fence?
Yes
No
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Will the gate be locked with a padlock?
Yes
No
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What type of fence and how tall?
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Is someone home during the day? Yes
No
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If not, where will the dog stay when alone?
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Where will the dog be kept most of the time?
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Why do you want a Rottweiler?
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If kept outside, will your dog have a run, house, or
kennel?
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Do you agree to spay or neuter this dog if it has not
been done already? Yes
No
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Will you take your dog to obedience
class? Yes
No
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Have you ever owned a
Rottweiler? Yes
No
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Where is that Rottweiler now?
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Do you prefer a male or female Rottweiler? Male
Female Doesn’t
Matter
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Age range?
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Is there a dog on our web site that you are interested
in? Which one?
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Will the Rottweiler be used as a guard
dog? Yes
No
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What other activities do you plan to do with your
Rottweiler?
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How many years do you plan to keep the dog?
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Other Pet Information
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Do you have other pets? Yes
No
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Type (list breed, age, sex):
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Are your other pets current on all vaccinations? Yes
No
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Are your animals on heartworm preventative?
Yes No
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Veterinarian’s name and phone number:
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Name the animals are listed under at the vet’s (yours and
the animals’):
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List the pets you have owned in the last ten years and
what has happened to them:
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How did you hear about Big Sky Rottweiler Rescue?
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We will attempt to provide you with an honest evaluation
of 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? Yes
No
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Are you willing to work with us on correcting these
problems? Yes No
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Please provide the name, address and phone number of
three references – at least 1 should be a neighbor if living in town. (only 1 family reference
permitted):
1)
2)
3)
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Comments: (please let us know the best time to
contact you!)
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I certify that the information provided on this form is true and 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 prior to approval for
adoption. BSRR retains the right to refuse my application if my
situation does not meet the adoption criteria.
I agree
I do NOT agree
You will be asked to provide a hardcopy, signed application prior to any
adoption being finalized. If you wish to save time, print, sign, and
mail this application to the address provided below.
SIGNATURE: _____________________________________________________
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PRINT and mail to:
Big Sky Rottweiler Rescue
P.O.
Box 221
Laurel,
MT 59044
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