FLRRR Pre-Adoption Application

You must complete all fields on the form. If completed correctly, you will receive a page with a big green check mark saying it has been submitted correctly. In addition, you will receive an email with your form responses. If you do not receive the submission congratulations or email, the information was not successfully submitted. If you have any questions, please email us at: admin@flrottweilerrescueranch.org

How did you hear about us?

Full Name*

First NameLast Name

Age

E-mail*

Address*

Street Address

Street Address Line 2

CityState

Zip Code

Phone Number - Home

Phone Number - Cellular*

Phone Number - Work

Do you live in a:

Do you:*

If you rent, please indicate landlord contact info*

First NameLast Name

*

Contact Number

If Renting: Please indicate landlord contact information

Do you live in a community with an HOA?:*

This field is required

If Yes: Please provide HOA contact information

Does your Landlord / HOA / Homeowner's Insurance have any restrictions or bans on having a Rottweiler?*

This field is required

Household Setting:

Describe Your Home Activity Level:

Please List all People Living in the Household (Include Name, Relationship, Gender and Age)*

Are there any children that do not live in the home, but visit your household? (Such as grandchildren, nieces, nephews, neighborhood kids, etc.)*

Does Anyone in Your Home Have Allergies to Pets?

Are all members of your Family agreeable to Adopting a Dog?

Please List any Pets you have Living or Deceased (Please include Name, Breed, Age, Altered, Sex, UTD Vaccines, Heartworm, Living/Deceased)*

Are you interested in a specific dog?

Dog's Name

Do You Have a Preference in Sex of Dog?

Are You Willing to Adopt a Dog of Any Age?

If not, what age would you consider?

Please describe the type of dog you are willing to adopt (Please include personality traits, energy level, etc) We always want to make sure we have the best fit for our adopted dogs and their new homes.

Are you willing to take your adopted dog to vet appointments and provide care for the course of their life, including monthly preventative?*

We cannot guarantee a dog to be housebroken, are you equipped to train with love and patience?*

Have you had any experience with an emotionally or physically neglected or abused dog?

If Yes please explain

Are you willing to use a crate for a dog if recommended?

Do you have a fenced yard?*

Please give details on height, material, # of gates, are gates locked or lockable?

How many hours in a day would the dog be left alone?*

What are you plans to exercise your new dog?

Vet Reference Information*

Name of Vet Clinic

Street Address

CityState

Zip Code

Phone Number*

Please list 2 personal references with names, addresses, phone numbers and how related. Please provide one family reference and one non-family reference.

Reference #1: Full Name*

First NameLast Name

Relation to applicant(s):*

E-mail

Phone Number*

Reference #2: Full Name*

First NameLast Name

Relation to applicant(s): *

E-mail

Phone Number*

By submitting this application electronically, I fully understand the contents herein and have no further questions.*

I acknowledge

I understand that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application can result in application rejection.*

I acknowledge

I certify that the above information is correct, and I understand that the information will be verified.*

I acknowledge

I agree to have Florida Rottweiler Rescue Ranch conduct personal reference checks.*

I acknowledge

I agree to have Florida Rottweiler Rescue Ranch conduct veterinary reference checks. Furthermore, I will authorize said veterinarians and/or veterinary clinics to release information, should such authorization be needed. This would apply to current living and/or last owned deceased dog, etc*

I acknowledge

I agree to participate in a virtual home visit, to both review the application, in “real time”, and virtually view both the home and yard space. This virtual visit is not meant to be intrusive. It is simply the final step in the application process and a step that all reputable rescues include, as part of their adoption process.*

I acknowledge

I hereby acknowledge that I have read all three pages, Adoption, Before You Adopt and Steps to Adoption, via the button links at the top of this page.*

I acknowledge

Signature

Clear

Your name*

Please enter your full name.

Today's Date

MonthDayYear

Acknowledgements