"Puppy Questionnaire"

Please fill out the form below, and send us your request by clicking the Submit Button at the bottom of the screen.This will assist us in placing the perfect puppy in the right home.

"Please Note"

Your Name::	*
Your Telephone Number::	*
Your Email Address:	*
Today's Date::	*
Your City::	*
Your State::	Alaska AKAlabama ALArkansas ARArizona AZCalifornia CAColorado COConnecticut CTWashington D.C.Delaware DEFlorida FLGeorgia GAHawaii HIIowa IAIdaho IDIllinois ILIndiana INKansas KSKentucky KYLouisiana LAMassachusetts MAMaryland MDMaine MEMichigan MIMinnesota MNMissouri MOMississippi MSMontana MTNorth Carolina NCNorth Dakota NDNebraska NENew Hampshire NHNew Jersey NJNew Mexico NMNevada NVNew York NYOhio OHOklahoma OKOregon ORPennsylvania PAPuerto Rico PRRhode Island RISouth Carolina SCSouth Dakota SDTennessee TNTexas TXUtah UTVirginia VAVermont VTWashington WAWisconsin WIWest Virginia WVWyoming WY*
Nearest Major City::	*
Which breeding are you interested in::	*
The sex of puppy you prefer::	MaleFemale*
Intent purpose for this puppy/dog?:	ShowWorkingBreedingCompanion*
Have you ever owned a Rottweiler before?:	YesNo*
What other breeds have you owned?:	*
What breeds do you presently own?:	*
How many animals do you currently own?:	*
How far will you travel to pick up your pup?:	*
Are you considering having your pup shipped?:	YesNo*
Living Accomodations?:	HouseApartment*
Do you have a fenced in yard?:	YesNo*
Number of children, sexes and ages?:	*
Number of hours a day your pup will be alone::	*
As a pup will your pup live primarily inside or outside?:	InsideOutside*
As an adult will your dog live primarily inside or outside?:	InsideOutside*
When do you plan to add a Rottweiler pup to your family? Within::	3 mos.6 mos.9 mos.12 mos.*
Other pertinent information you feel would be helpful?:

(Fields marked with * are required)

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