Puppy Application

Your name, address, phone number

Email Address:
How did you hear about us?
What gender are you looking for? Male Female Either
Show Quality Pet/Companion
Have you owned a Rottweiler Yes No
Do you have any kids? Yes No
Do you have stairs in your home?
Do you have a swimming pool? 
Do you already have dogs? Yes No

If yes, what breeds and how old are they?

Where will the dog be kept during the the day? At night?

Do you have a fenced yard? Yes No
Are you aware of the health concerns with this breed? Yes No
If you are wanting a show dog, have you shown before? Yes No
If we don't have puppies now, would you like to be put on our waiting list? Yes No

Please list any references or your veterinarian below

May we check your references and information given ? Yes No
Here is your chance to tell us anything else about you, or what you think we should know about you.

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Thank you for your interest and taking the time to fill out the application!