Puppy Questionnaire

This application is just a beginning step in the interview process.

All information will be confidential and used only by the Breeder/Owners of this litter.

Thank you for your cooperation and interest.

Please complete the entire form below.

First Name_____________________________________________________ Last Name _____________________________________________________ Address _______________________________________________________ City __________________________________________________________ State _________________________________________________________ Zip Code ______________________________________________________ Home Phone_________________________________________________________ E-Mail ________________________________________________________

How did you learn about superior-size-rottweilers.com?

Do you currently own other pets?

If so, please describe (species, breed if a dog, and age)

If you do not currently have a dog, have you owned a dog(s) before?

If so, what breed(s)?

What happened to that/those dog(s). If they are deceased, include how/why they died and at what age ?

Why have you chosen a Roman Rottweiler to become a part of your family?

Are you familiar with the Rottweilers grooming requirements, temperament, nutritional needs, and activity level?

Have you visited the American Rottweiler Club of America website (http://www.amrottclub.org/index.html) and/or have done other research on this breed?

Do all family members what a new puppy?

Are there children in the family?

If so, please state their gender and ages

Do any family members have allergies to dog?

Are any family members afraid of dogs? If so, please explain

Are there restrictions in your neighborhood regarding dog ownership?

Do you have a securely fenced yard?

Do you padlock your gates?

Do you have a chain-link kennel run?

If “yes”, what size

Please describe your yard size and fencing.

If your yard is not fenced or you do not have a chain-link kennel run, would you be willing to have it installed before you bring home a new puppy?

Do you have a swimming pool?

If “yes”, is your pool fenced to prevent a puppy/dog from swimming unsupervised?

Do you plan travel with your dog?

If “no”, where will your dog stay during your vacations? (boarding kennel/veterinarian/stay with friends/other). Boarding Kennel Veterinarian Stay with Friends Other If “other”, please describe

What gender do you prefer? (male/female/no preference)

If you have selected a preference, would you be willing to take a puppy of the opposite sex if your preference is not available?

Rottwielers live approximately 10 to 14 years. Are you committed to care for this Rottweilers needs throughout his/her lifetime?

Who will be the primary caretaker --feeding, training, exercising, socializing, and grooming-- for this Rottweiler?

Have you ever crate trained a puppy or a dog? If “no”, please describe

Do you feel we can maintain a long-term relationship to discuss the health and welfare of your Rottweiler?

Please include any comments that will help us place the right puppy with you.

By submitting this application, I am acknowledging that the information entered is true and correct. I understand that sending this application does not automatically entitle me to a dog. I understand that this application is just a beginning step in the interview process.

Please review and then submit this completed questionnaire. You may copy and paste this information in Microsoft word or any other word processor, fill in the questions and email me the information back.