I would like to: * Foster Adopt
Age *
Co-Applicant Name
Co-Applicant Age
Street Address *
City *
Zip Code *
Home Phone *
Cell Phone *
Email *
Best Time to Call * Morning Afternoon Evening Anytime
Place of Employment *
Why do you want to adopt a Great Dane? *
Do all household members want to adopt? * Yes No
Have you owned a Great Dane * Yes No
What would be your preference in a Great Dane? * No Preference Some Preference
Please explain: (color, age, gender, etc.)
Do you consider yourself/family to be active in such a way that it would include your Dane? * Yes No
Please explain: *
If your dog is not spayed/neutered, please explain why:
Please list all cats current and previous (name, gender, age, breed, spay/neuter, living/deceased): *
If your cat is not spayed/neutered, please explain why:
Other animals? *
Have you ever sold, rehomed, surrendered or put down a pet? * Yes No
If yes, please explain:
If there are no children living in your home, will your rescue Dane have regular contact with any children under the age of 8? * Yes No
If yes, please explain:
If there are no other pets living in your home, will your rescue Dane have regular contact/socialization with others? * Yes No
Please explain: *
Does anyone in your household have allergies or asthma? * Yes No
If yes, who and what kind?
Are you aware that dogs can shed all year around? * Yes No
Who will care for, train and exercise your Dane? *
How will you exercise your Dane? *
If you do not currently have a dog, have you ever owned a dog in the past for which you were the primary caretaker? * Yes No
If yes, please explain:
Veterinarian address? *
Veterinarian phone? *
Do you own or rent your home? * Own Rent
How long at current residence? *
If you rent, has the property owner provided written permission for you to have a large breed? * Yes No Not Applicable
Please provide the property owner's name and contact number:
Do you have a fenced yard? * Yes No
If yes, please describe (completely enclosed, shade, height, gates):
Where will the Dane live? *
Where will the Dane sleep? *
Where will the Dane eat? *
Will the Dane be allowed on furniture? * Yes No
Will the Dane be allowed free run of the house? * Yes No
How many hours per day will your dog be home without humans on a regular basis? *
Where will the Dane be kept when you are not home? *
Are you familiar with the use of a dog crate to train and/or confine the dog during your absence or at night? * Yes No
Are you planning to use a crate? * Yes No
What do you do with your pets when you're away from home overnight? *
Are you aware that costs for maintaining a Dane can average $1000 or more per year (food, annual check ups, shots, heartworm and flea/tick preventatives, grooming, etc.)? * Yes No
Will the Dane be walked daily? * Yes No
Have annual check ups? * Yes No
Receive formal obedience training, if needed? * Yes No
If you move, what will you do with your Dane and other pets? *
Would you allow follow up home visits from a rescue representative before and after adoption? * Yes No
Are you aware of and do you understand the state/local ordinances concerning dog licensing and leash laws? * Yes No
Has any member of your household been cited for licensing or leash law violations? * Yes No
If yes, please explain:
Will you call SSGDR at the onset of any type of illness or health problems within 30 days following adoption? * Yes No
What would you do if one of your pets requires significant/costly medical attention? *
Are you willing to give the new Dane at least 30 days to ensure proper adjustment? * Yes No
If no, please explain the conditions you would return:
Have you researched Great Danes? * Yes No
Any questions or comments to the rescue?
How did you hear about us?
If a Great Dane is placed with me/us, I/we agree to cooperate with Southern Style Great Dane Rescue in its attempt to provide a smooth adoption. I also agree to contact SSGDR about problems that might arise in the future. Should the dog need to be removed, or euthanized (prior to normal old age), I/We will contact Southern Style Great Dane Rescue first to determine whether the dog might be a candidate for placement elsewhere. By submitting this application, I certify that the information that I have provided is true, correct and complete to the best of my information and belief and that I have not willfully concealed any information in answering the above questions. * I Agree