MRR Adopt

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					                            Majesty Rottweiler Rescue Inc.

                                            Adoption Application
Please answer all of the following questions, your application will not be considered unless all questions are
answered. Upon completion, please return this form to ~
Terry by e-mail or if you prefer please mail your completed form
to: Majesty Rottweiler Rescue
    P.O. Box 493
    Darlington, Md 21034-0493

Your full name and birth date including year, if married also include maiden name:
Your Home Address City, State & Zip code:
E-Mail Address:
Home Phone Number:
Your employer & phone #:
How many hours a week do you work?
If you are self employed, what is the name of your company?

Full name and birth date of spouse or significant other in the home:
Spouse’s employer:
How many hours a week does your spouse work?

Names and ages of all children or Family members living with you:
What would change if you were to have Children after you adopted, please be specific?

Who if anyone other than family and/or children, reside with you?
Please name them, list their relationship and ages:

Does anyone in the family have allergies to pets?          If so, please explain?

Are you seeking other avenues to attain a Dog such as other Rescues or Facilities?
If so please give the Name and phone # or e-mail address of that organization?

Is there a certain Dog you are interested in, if so who?        If yes and he/she is no longer available would you
be interested in another?

Would a male or female Rottweiler fit better in your home?
Do you prefer an age range, if so what is that age range?
Would you accept a Rottie with a natural tail? If not, please explain why you wouldn’t?
Any other criteria for a Dog you would like to adopt?

If other dogs or cats live in the home, how do you plan to introduce them to the new Family member?

Do you rent or own? Is your name listed as the owner of your residence? If not please list the owners full

If you rent, please provide the name and phone number of your landlord;
(a form stating it is alright to have a Rottweiler will be required from your Landlord)

Please choose one, is this a house, condominium, apartment, or mobile home?

How long have you lived at this address?
If less than two years, please list your previous address and landlord:

Do you have a homeowners or renters insurance policy?
If so, what is the name of insurance company?
Have you checked with your insurance company to make sure they do not have a Breed ban against
Rottweiler’s? (if not, please do so before sending your application to us, if your insurance company does have a
breed ban on certain Dogs and you are willing to change companies, we do have a list of insurance companies who
allow Rottweilers and will share) PA residents are not subject to this requirement because of the Pa. state law
forbidding insurance companies to practice BSL.

If your insurance company practices BSL are you willing to change insurance companies?

Is there a chance you might move in the next 10 years?
If so, are you willing to restrict your choice of housing to places where a Rottweiler is allowed?

Do you have a fenced yard?
If so, how large is the fenced area?

If yes, what type of fence is it and how tall?
(we do not accept invisible fencing for obvious reasons)
Is the fence secured underground as well?
(meaning securely in the ground with no openings for Dog to escape underneath)

Do you currently keep the gate padlocked?

If you do not have a fence would you consider putting one up?

If you do not have a fenced yard please explain how you will allow the Dog to defecate/urinate and be properly

How often and what distance do you walk your Dogs?

Will the Dog be kept indoors or outdoors?

Do you plan to keep the Dog in one certain area of the home, if so why?

What brand of Dog food do you feed your Dogs? If you don’t have a Dog presently, what did you feed your
previous Dog?

Are you aware of the importance of feeding a high quality Dogfood?

Please describe where and how the dog will live, on a typical day:

Is someone home during the day?          If not, where will the dog stay while you are gone?

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

Do you have a crate?
If so, what type and size is the crate?
(the plastic Vari kennels/crates are for airline use and not acceptable for everyday use)
If no, are you willing to purchase a crate, if needed?

What will happen to your Dog when you go on vacation or have to go away from home?

Have you ever owned a Rottweiler?
If so, from whom did you get him/her? (breeder, rescue etc. please give name)

Please give name or company of the Trainer you used to train your present or previous Dogs?
Did you go to training class with your Dog or send him/her to the Trainer?
If you did not go to obedience class but trained your dog yourself, what type of training did you use?

Do you currently have any pets?
If yes, please give names ages and breeds of all pets including any Rotties you may have at this time:

Are your Dog’s or were any previous Dog’s on heartworm preventative?         What type?
If you do not/did not give your dog’s heartworm preventative please explain why.

If you own or have owned a dog, were they or are they spayed/neutered and current on vaccinations?
If not, please explain why they are/were not:

Approximate date of your current pet's last office visit?

Please list all Animal’s you have owned in the past 10 years; Please give names, ages, breed and what has
happened to them if they are no longer with you. (If deceased, please give the reason of their demise.)

Have you ever given any of your Pets away to anyone or surrendered them to a Rescue or Shelter? If so
please give the name and phone number of the person to whom you surrendered the Pet and please explain
why you gave your Pet away.

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

Do you know the city animal ordinances/licensing procedures in your area, if so what are they?

Do you have a city or county ordinance that limits the number of dogs you are allowed to have in your home?
If yes, how many are you allowed to have?

Please explain why you wish to adopt a Rottweiler:

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

We will attempt to provide you with an honest evaluation and temperament of any dog we adopt to you, do you
realize that sometimes 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?

Are you willing to take the adopted dog to obedience classes?      Why or why not?
If you live within an hour of Clarksville, Md are you willing to take your adopted Dog to Karen Decker for
classes once a week until they graduate?

What behavioral/training issues ‘can’ you deal with?
What behavioral/training issues are you ’not’ able to deal with?

If you were to return this (or any) dog, for what reason would it be?

If you and your significant other separated what would happen to the Dog?

What length of time are you willing to give a Dog to adjust to your home?

How did you hear about Majesty Rottweiler Rescue?

Please list your Veterinarian’s name address and phone number, if you have recently changed Vet’s or do not
have pets at the present time, please list the name and number of your previous Veterinarian as well as the one
you are now using.
Please list the names, addresses and phone numbers of three references, other than relatives who have been to
your home:
I certify that the above information is true and I understand that prior to being approved for adoption, the
above information will be verified. In all cases, a home visit will be required. I also agree to a personal
interview with a member of Majesty Rescue to determine the suitability of my home to care for a canine. I also
understand that if at any time Majesty Rescue feels the dog is not being cared for properly, or feels the dog is
being abused, Majesty Rescue will take back possession of the dog. In the event that you can no longer keep
the dog, Majesty Rescue must be notified immediately so they may make arrangements for that Dog.

 I understand and agree that falsification of any of the above information is grounds to disqualify my adoption
application and nullify all adoption(s) and/or adoption agreements between the applicant and Majesty’s
Rescue. I also understand and agree that my Adoption Application may be shared with other Rescue groups
for reasons not limited to helping to find a Rottweiler to join your Family.

 Agreement; You understand and agree that by signing, clicking on "I agree" or a similar entry field your
agreement or consent will be legally binding and enforceable as the legal equivalent of a handwritten signature.
I authorize Majesty to attain any information needed from the above references as well as any other resource
deemed necessary to assure suitability for adoption or foster care. Please initial here (    )

Please be sure every question has been answered, then sign and date below, if all questions are not answered
your application will not be considered. (if something does not pertain, please note the reason why it does not
pertain to you)

I Agree; Applicant (s) signature here:             Date:

Please put any notes you would like me to know or questions you may have here;