Rottweiler Breeder - Rottweiler Puppies - Rottweiler Stud Dog - Esmond Rottweilers | Mike Jackman & Ann Felske Jackman | Ontario Canada



The purpose of this questionnaire is to help us to match each of our puppies to the perfect home for that pup.   Please fill out this questionnaire in full press the "SEND" button. 

*Please realize that completing this questionnaire is in no way a committment on your part to purchase a puppy from us, or on our part to place a puppy in your home.  It is simply a way to get to know you better.  If it appears that we could be breeding the type of dog you are looking for, we will set up a time for you to come to meet the dogs, or begin communicating via phone/e-mail if you are not local.  In the event that we don't think we'll be able to produce the puppy you are looking for in a reasonable time frame, we will give you suggestions as to who to contact next.  Thank you for your interest in our pups and best of luck in your search.




City, State/Prov              

Phone Number:              

Your email address:       

Who were you referred by? 

Are you looking for a  Male   or  Female?   
                                   Puppy or  Older Dog?                  

This dog is to be a:     Show Prospect   Working Dog  Companion Only

To compete in:           Agility     Obedience  Schutzhund   Herding
                                   Tracking  Flyball        Therapy         Other - explain below


Is there a specific litter you are interested in?     Yes   No

If so, please tell us which litter, and why...

What specific qualities are you looking for in a Rottweiler?  

What are your goals for this dog?

Tell us about your family:  
How many adults live in your home? 
How many children?  Ages of children
How many dogs live with you now?  
Any other pets?      

Tell us more about your family, pets, lifestyle, work schedules etc.

Tell us about your home:
Is the area that you live in Rural   Suburban   City?
Do you Own or  Rent?
Will the dogs live Indoors or Outdoors?
Will this dog have access to a fenced yard?     Yes   No
Are you comfortable crate training your pup?  Yes   No

Tell us about your experience with dogs.  List all dogs you have owned and what happened to them.
List any dog-related clubs you belong to. List any titles that you and your dogs have achieved.
Have you reviwed our Sales Contract, and are you willing to abide by this agreement?  
Do you have contract questions?
Please provide us with two references. 
If you have previously owned a dog, one of the references must be a breeder, veterinarian, or trainer.

Please include any additional information that you would like us to consider:

Are you willing to travel to pick your puppy up?   Yes   No

If we do not have anything available that will meet your needs, can we forward this application to 
another reputable breeder?    Yes   No