Adoption Application

Mailing:                                                                                                                                                                                               

*Name
*Address
Address (cont.)
*City
*State
*Zip

Contact:                                                                                                                                                                                               

*Home Phone
Alt Phone
*E-mail

References:                                                                                                                                                                                          
We would prefer that at least one reference be a neighbor, and that you provide at least 2 references.

Neighbor:

*Name
*Phone
Email

References:

Name
Phone
Email

Name
Phone
Email

General Questions:                                                                                                                                                                             

What variety (color) preference:

Fawn Brindle Black Blue Harlequin Mantle/Boston Merle No Preference

Would you consider another variety?

Yes       No

What SEX preference?

No Preference
Male
Female

What AGE Preference?

No Preference
Adult
Puppy (note: puppies are rare, you may want to seek a breeder)

Have you ever owned a Dane or other large breed dog?

Yes     No

Your Home:                                                                                                                                                                                         

Do you have CHILDREN in your home?

Yes     No

If yes, what are there ages?

Do you have OTHER PETS in your home?

Yes     No

If yes, please list other pets:

Do you OWN your home or RENT?

Own
Rent

If RENTER, Landlord's name and phone req'd.

Name
Home Phone
E-mail

Is your yard fenced?

Yes      No

Will the dog be housed indoors?

Yes      No

If answer is no, please describe outdoor facility.

Veterinarian                                                                                                                                                                                        

Name
Phone
Email

Discipline:                                                                                                                                                                                            

What type of discipline do you use with dogs?

Additional Information:                                                                                                                                                                     

Please enter any additional info that you think will help us find the right Great Dane for you.

By submitting this application the applicant certifies that they are at least 18 years old and that all information given is true and correct to the best of their knowledge. Any false or misleading information provided by the applicant shall be cause for rejection of this application.