Adoption Application Form - Rottweiler Rescue of Western Australia Inc

If you are interested in adopting one of our rescued Rottweilers, please complete and submit the form on this page. Please note, we are located in Perth, Western Australia.

Click here to download a printable version of this form



Address:    City, Postcode:

Home phone:         Work Phone:         Mobile:   

Email Address:

What is your age bracket?: Under 18      18 - 30 years      31 - 40 years      41 - 50 years      51+ years

Which dog are you interested in adopting?:
(leave blank if you don’t have a preference)

Why do you want to adopt a Rottweiler?:

Have you owned a Rottweiler before: Yes     No
If yes - When and for how long?  

What do you know about Rottweilers?


Spouse/Partners Name (if applicable):

How many adults live in your household?:      How many children?:
(Over 18 years)

What are the ages of the children in your household?:

Are all family members willing to care for a new dog?:    Yes    No
If no, please give details: 


Do you currently live in:   House    Apartment    Acreage   Other
If other, please give details: 

Do you own or rent?:    Own    Rent

Describe the living area that will be made available to the dog (also please include access to house and yard details):

Do you have a fenced yard?: Yes     No
If yes - How high?      What material?:


What pets are currently living in the home (number, type, breed, age, sex)?:

What pets have you previously owned and what happened to them?:

Are all your pets currently vaccinated?:    Yes    No
If no, please give details: 

Are all your pets castrated or speyed?:    Yes    No
If no, please give details: 

Who is your veterinarian?:    Phone:


Do you have experience with, or are you willing to adopt a dog whom may suffer from extreme shyness, anxiety, fear of objects or people, blindness, deafness or those recovering from surgery?:    Yes    No

If yes, please give details: 

Will your new dog be allowed in the house?:    Yes    No

Where will the dog sleep?:

What amount of time will your dog be alone of a typical day?:

Weekdays:   hours

Weekends:   hours

Where will this Rottweiler be kept when alone?:

Do you plan on taking this Rottweiler to Obedience classes?:    Yes    No

Are you familiar with crate training?:    Yes    No

Are you willing to crate train or learn how to crate train your new dog?:    Yes    No

It is likely that small disagreements are going to occur when bringing a new dog into your home where there are already dogs or cats existing. There can be fear or anxiety and you must be willing to work with your new dog and existing pets during the transition (with our help) over what could be days or weeks. Are you willing to make this commitment?:    Yes    No


I certify that the information I have provided on this form is true, correct and accurate. I am financially and physically capable to care for the animal that I adopt. I understand that there is no obligation to adopt an animal to me, now or in the future. I understand that my electronically generated signature [below] is valid as a means of legal signature for the purpose of this adoption application.




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Rottweiler Rescue of WA Inc.
Rottweiler Rescue of WA Inc.