Your Email (required)
City, State, Zip
Will you accept a collect call from us (if you are out of the Chicago area)? Yes No
Best time to call (include time and day)
Number of Children
How long have you lived at this address
If less than two years, please list your previous address
Which best describes your current living situation HouseCondoApartmentMobile Home
Do you OwnRentLive with parents
If you rent, Name & phone number of Landlord
What type of environment? CitySuburbanCountry
Besides your immediate family, are there others residing in your home Yes No
Names & ages
Does your home have a yard Yes No
Type of fence and how tall?
Will gate be locked with a padlock? Yes No
Is fence secured underground as well? Yes No
Is someone home during the day? Yes No
If no, where will the dog stay while you are gone?
Where will your dog be kept most of the time? In house Outside Basement Other
If other, please specify
If kept outside, will you have a dog run/dog house? Yes No
(Dogs are not to be chained or tied out and left at any time)
Will you take your dog to obedience class? Yes No
Have you ever owned a Rottweiler? Yes No
Tell us about your rotts
Do you prefer a male or female Rottweiler? Male Female Either
Is there a dog on our web page that you are interested in? Yes No
Name of Rott
Why do you want a Rottweiler?
Will the Rottweiler be used as a guard dog? Yes No
What other activities do you plan to do with your Rottweiler?
Other Pet Information
Please list other pets
Please list all current vaccinations?
Are your animals on heartworm preventative? Yes No List type below
Are you willing to pay for a heartworm test? Yes No
Veterinarian's Name & Phone Number
If applicable, approximate date of your current pet's last office visit
If you have owned other dogs and do not now, what happened to them?
How did you hear about Recycled Rotts, Inc.?
List any Humane Societies, Organizations, Breed or Training Clubs you are associated with
We will attempt to provide you with an honest evaluation of temperament on any dog we have to place. Do you realized that often times the complete history of a Rottweiler may not be known and you may encounter some behavioral problems?
Are you willing to work with us on correcting these problems?
Please provide the name, address and phone number of three references
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. Home checks are made on a random basis following or prior to adoption. If upon inspection we find that information contained in this application to be false, we retain the right to turn down or remove the animal from your premises without a refund of moneys paid.
We require a hard copy of your signature prior to adoption certifying the above information. You may also print the form out and mail it, with your signature to:
Recycled Rotts Inc.
PO Box 1082, Oswego, IL 60543
Recycled Rotts, Inc. | PO Box 1082 | Oswego, IL 60543 | (630) 551-0729 | Donations | Alumni Gallery | Memorials | Vets | Event Sponsors/Misc. Links | Home ©2017 Recycled Rotts, Inc. All Rights Reserved. | Editor