Please
COMPLETE this questionnaire.This
will help me pick out the very best dog for you, your family and your lifestyle.Please
answer all questions fully.We LOVE
our dogs very much and want them to go to the appropriate and best home
possible as they are our FAMILY.Thanks
for taking time to complete the questionnaire.Please
send to Theresa Raymond, VON KILTZEN,
1400
State Rte 69,
1)Name______________________________________________________________________
2)Address_____________________________________________________________________
3)City_____________________________State__________________Zip
Code_____________
4)Telephone
numbers: Home____________Work____________Email:_______________________________________
5)Employer:___________________________________________________________________
Occupation______________________________________Shift________________________
Average
hours worked weekly________________________
6)Number
of adults living in your household______________
Hours
that they are home (include yourself) ______________________________________________________________________________
7)Number
of children living in household_________ Ages_______________________________
8)What
type area do you live in? City____Suburban_____Country_______
9)What
type of housing?Apt___Condo___Duplex___House____Other____________________
If
you rent or lease, do you have permission from your landlord to own a dog?Yes____No___
10)What
breed of dog have you previously owned, and what happened to them?Please
list.
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Were
they spayed/neutered?Yes___No___
Did
you ever breed a dog that you owned?Yes____No____If
so how many litter, etc
____________________________________________________________________________________________________________________________________________________________
11)Other
pets in the household- breed, age, spayed/neutered? ______________________________________________________________________________
______________________________________________________________________________
12)What
do you know about the Rottweiler as a breed?_________________________________
____________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________
13)Why
do you want a Rottweiler?_________________________________________________
____________________________________________________________________________________________________________________________________________________________
______________________________________________________________________________
14)How
did you hear about this puppy and who referred you to us? ___________________________________________________________________________
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2
15)What
other litter(s) have you looked at?__________________________________________
______________________________________________________________________________
16)Do
you have a preference as to what sex the puppy is?Yes____No____
If
yes, why?_________________________________________________________________
17)Do
you have a fenced in yard?Yes___No___
Specifically what kind of fence and how tall is it?_________________________________________________________________________
If
not fenced, where will the puppy be exercised and allowed to eliminate?
______________________________________________________________________________
______________________________________________________________________________
18)What
member of the family will be taking the MAJOR responsibility for raising
the puppy?
_____________________________________________________________________________
19)What
are your plans and goals for this puppy?_____________________________________
______________________________________________________________________________
______________________________________________________________________________
20)Would
you take your puppy to an obedience class?Yes_______No_______
21)Have
you ever been to a dog show?Yes_____No_______
22)Will
the puppy live in the home?Yes_______No_______
If
not, where________________________________________________________________
23)Where
EXACTLY will the puppy sleep at night and be kept when there is no one
at home?
____________________________________________________________________________________________________________________________________________________________
24)Have
you ever used a crate before?______________________________________________
Do
you have an objection to using a crate?________________________________________
25)What
are the major activities, hobbies, or exercises that you and your family
participate in most?_________________________________________________________________________
26)Please
list your veterinarian’s name/address/phone number.Call
your vet & advise them that I may be checking on the health care of
your previous/current pets.
____________________________________________________________________________________________________________________________________________________________
27)What is your estimate of
cost for your puppy’s first year?(example
vet expense, food, toys, training, etc)____________________________________________________________________
28)Please
list names, address and phone number of three personal references that
have known you for at least two years ______________________________________________________________________________
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
29)Do
you currently belong to a kennel club?Yes____
No____If so, what club(s)? ______________________________________________________________________________
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3
POTENTIAL
SHOW HOMES PLEASE FILL OUT THE FOLLOWING AS WELL AS THE PREVIOUS SECTION:
1)How
many dogs do you currently own (that live with you)?______All
Rottweilers?_______ _____________________________________________________________________________
2)Where
exactly do your dogs live?________________________________________________
______________________________________________________________________________
3)How
long have you been showing dogs? ______________________________________________________________________________
4)How
many litters have you bred?____for a total of
_____puppies?When did you have
your first litter? _____________________________________________________________________
5)What
titles have you obtained on dogs you owned
?__________________________________
______________________________________________________________________________
What
titles have been obtained on dogs bred by you? ______________________________________________________________________________
6)If
you have bred a litter, where exactly are your puppies whelped and raised?
_____________________________________________________________________________
______________________________________________________________________________
7)Do
you show your dogs yourself or do you hire a handler?_______
If you hire a handler, who do you use?? (list
all) ______________________________________________________________________________
____________________________________________________________________________________________________________________________________________________________
Do
your dogs travel with them?__________________________________________________
8)
What will you do with this dog if it does not turn out to be show quality?
______________________________________________________________________________
______________________________________________________________________________
9)What,
if any, health problems have your previous dogs had? ______________________________________________________________________________
____________________________________________________________________________________________________________________________________________________________
10)
What kind of food do you feed? ______________________________________________________________________________
What
supplements, if any, do you use?____________________________________________
______________________________________________________________________________
11)Who
have you purchased dogs from in the past? (list
all)_____________________________
______________________________________________________________________________
______________________________________________________________________________