Thank you for your interest in adopting a pit bull or rottweiler from A Rotta Love Plus.


This questionnaire is intended to be a guide to help you think about all the ways a Rottweiler or bully breed will impact your life and to help determine if this is the right breed for you. The information you provide on this application will help us to find the best possible match between you and the dogs available through A Rotta Love Plus. All of the questions concern various aspects of dog ownership that should be given serious consideration before deciding to share your life with any dog. It is by no means meant to be a test that will be used to disqualify you from consideration.

Before filling out the application, please note the following reasons that your application will be declined:

Your homeowners insurance does not cover the breed. Several major insurance companies such as American Family will deny or cancel your homeowners insurance if you choose to own a Rottweiler or Pit Bull. Frankly, even if you choose not to adopt we don't think you should spend your money with a company that discriminates. Not all major insurers feel this way however...State Farm for instance bases is coverage on the behavior of YOUR dog, not it's breed.

You live in Wisconsin or Iowa - we have made this decision based on the fact that BSL is running rampant in WI and IA at the moment. There are rare exceptions to this rule. PLEASE check the laws in your town prior to adopting any Pit Bull or Rottweiler.

You are adopting the dog as a surprise and/or a gift - ALL members of the family must meet the dog prior to adoption.

The dog will be an outside dog - All dogs adopted through A Rotta Love are expected to live inside as a member of the family.

 

Me and my Family

Name of dog you are applying for:

Your full name:

Address:

City: State: Zip:

E-Mail Address: Home Phone Number:

Your employer: Your work phone

Hours you work:

Names and ages of all children living with you:


If you do not have children, do you plan to have children someday? If yes, explain how this will affect the dog’s place in the household?

Who, besides immediate family and/or children, reside with you? Please list their name, relationship, and ages:

If you have children, are they experienced around dogs? Explain what their level of
understanding is.

Does anyone in your house have allergies (not just animal related)? List them in detail:

Your residence

Do you rent or own? Rent Own

If you rent, please provide the name and phone number of your landlord:


List your insurance agents name and contact number or email address. This is VERY
important -- many insurance companies will NOT cover you if you own these specific
breeds of dogs. **This field is required**


Is this a house, condominium, apartment, or mobile home? Explain.


How long have you lived at this address (years/months)?

If less than two years, please list your previous address and landlord, if applicable:


Is there a chance that you might move within the next 10 years? Yes No

If so, are you willing to
restrict your choice of housing to places where a Rottweiler or Pit Bull is allowed?


How much of a housekeeper are you? How do/would you deal with pet hair on
floors/furniture etc.? How do you feel about drooling?


Do you know your city animal ordinances/licensing procedures? Yes No

What is the licensing fee?

What is the limit of pets per household?

Your Yard

Do you have a fenced yard? Yes No

If yes, what type of fence is it and how tall?

If no, do you have a kennel area? Yes No

If you do not have an outside kennel or fenced yard, please explain how you will allow
for the dog to defecate/urinate?


Do you currently keep the gate padlocked? Yes No

Do you have a pool? Yes No

If yes, is it fenced separately? Yes No

Care & Responsibility

Will the dog be kept indoors or outdoors? Indoors Outdoors

Where will the dog sleep at night?

Please describe where/how the dog will live and/or a typical day for the dog:


How many hours per day will the dog be left alone and/or crated?

Do you have a crate? Yes No

If no, are you willing to purchase a crate? Yes No

Do you travel? If yes, who will care for your pet when you are out of town?


What steps have you taken to learn about this breed and/or dog ownership?


Are you prepared to deal with and afford any medical emergencies? Explain.
How much, in your opinion, does it cost to have one dog per year? Include training,
food, vet visits, etc.? Or, if you keep a yearly budget for your pets, what would it be?

History of Pet Ownership

Do you currently have any pets? Yes No

If yes, please describe the pets in detail (age, breed, sex, personality):


If you have cats, have they been around dogs before? How do they react? Will they
run from a dog or not pay attention to them? Do they have claws?


Have your current pets been through obedience class? Yes No

Where?


If you own or have owned a dog, is it/was it spayed or neutered and current on
vaccinations? Yes No

If not, please explain why:

If there were previous dogs, what happened to them?


Do you enjoy brushing or grooming your pet(s)? How often do you do this? How about
nail trims?


What do you enjoy most about dog ownership?


What do you like least about dog ownership?


What type of food/treats do you feed?


Do you belong to any kennel clubs, obedience clubs, or other dog-related clubs? If
yes, please list and describe:

Why a Rottweiler/Pit Bull?

Please explain why you wish to adopt this breed of dog.


Have you previously owned a Rottweiler or Pitbull?


How did you first learn about the Rottweiler or Pitbull?


Please explain what you like about this particular dog



What other breed of dog have you considered?

Have you and your family discussed the pros and cons of owning a Rottweiler/Pitbull?

Behavior & Training

Are you willing to take the adopted dog to obedience classes? Yes No

Why or why not?


What behavioral/training issues CAN you deal with? What behavioral issues can you NOT deal with? List them below and be specific.
(Just some things to think about: Chewing, housebreaking, barking, whining, marking, Pacing & panting, Food Aggression, Leash Pulling, chasing other pets, not listening to commands, challenging existing pets for pack leadership, puppy nipping/mouthing, jumping on people, jumping on furniture, digging in the cat litter box, protective of toys, stress out at vet’s office, difficult to cut nails or groom)


Do you understand that the dog will take time to adjust in their new home and certain behavioral issues might occur? How do you plan to deal with this should it happen?


If you were to return this (or any) dog, for what reason would it be? (Think about things that could change your life such as: new baby, moving, behavior problems, divorce, financial stress, new relationship, job change, new furniture)

References

Please provide the name and phone number of your veterinarian (current and/or previous):


List the names, relationship to you, address and phone numbers of THREE other references:
1.
2.
3.

Preferences

Would you prefer a male or female?
Male Female

Do you have an age preference?
(i.e. 3 months, 6 --- 12 months, 1-2 years, 3 + years, Senior)
3-6 Months 6-12 months 1-2 years 3+ years Senior

Are you willing to accept a dog with special medical needs?
Yes No

How did you find out about A Rotta Love Plus, Inc.?

Thank you for completing this questionnaire. By entering your name below you certify that the above information is true and understand that prior to being approved for adoption, the above information will be verified. In most cases, a home visit will be required. You also agree to a personal interview with a member of A Rotta Love Plus. Incomplete applications will not be reviewed.


Applicant Signature(s):

Thank you for your interest in a rescue dog and in A Rotta Love Plus!