| Name | |
| Address | |
| Phone : H / W | |
| Email Address | |
| Best Time To Call | |
| Do you live in a (select one) | House |
| Apartment |
| Duplex/Fourplex |
| Trailer |
| Other |
| Do you own or rent? | Own |
| Rent |
| If you rent, do you have your
landlord's permission to have a dog? | Yes |
| No |
| Landord's name and phone number: | |
| Do you have a fenced yard?
| Yes |
| No |
| If yes, please describe. (Type & Height) | |
| If you do not have a fenced yard, what
means of daily exercise will you provide for the dog? | |
| Do you currently have any
pets? | Yes |
| No |
| If yes, please specify type, age, breed,
gender, include for each if they are spayed or neutered. | |
| List any pets that you have owned in the
past 3 years and what has happened to them. | |
| Who is your current Veterinarian? (name
of veterinary clinic, name of veterinarian you see most often, and telephone number) | |
| Do you have children in the household?
Please list their ages and gender: | |
| Have you or any member of
your immediate family ever been convicted of a charge of or related to cruelty to animals? I | Yes |
| No |
| Will a family member be at home during
the day? If so, who? If no, how long will the dog be alone during the day? | |
| Why would you like a Great Dane, and how
did you choose this particular breed? Have you owned any Great Danes before? | |
| What do you think it costs to feed and vaccinate a
Great Dane for a year? | |
| Have you asked yourself if your lifestyle
can accomodate a large dog? Are you constantly busy with a very hectic lifestyle, or will you be able to meet the needs of
a dog that needs regular exercise and attention? | |
| Do you want to adopt: | Male |
| Female |
| Doesn't
Matter |
| What age(s) would you consider? | Puppy |
| Young |
| Adult |
| Senior |
| Doesn't
Matter |
| Would you be willing to adopt a Great
Dane with one of the following handicaps? Physical, Deaf, Behavioral, Old. Please explain yes or no. | |
| Where will your Great Dane
spend its day? | Loose Indoors |
| Loose Outdoors |
| Crate |
| Basement |
| Garage |
| Fenced Yard |
| Tied Up Outside |
| Kennel Run |
| Other |
| Where will the dog spend the night? | |
| How much time per day do you expect to spend with your
Great Dane? | |
| Where will the dog stay when you are gone
overnight or on vacation? | |
| Do you expect to be able to care for your
Great Dane for the rest of its lifetime? What kind of circumstances would force you to give up your dog? If something happened
that did require you to give up your Great Dane, what would you do to find it a new home? | |
| Please List 3 Personal References (include
phone numbers) | |
| |
