Personal Information: Full Name: * Spouse Name (if applicable) Address: * E-mail * Phone Number: Cell: Do you have any children: * Yes No What are their ages: Are there others residing in your home? Please List: Are you Military? Yes No Residential Information: Do you rent or own: * Rent Own Apartment House Condo House Trailer If Rent: Who is your Landlord? Contact Information for Landlord: Have you received permission from your Landlord? Yes No How long have you lived at this address? * If less than two years what was your previous address? Do you have a fence around your yard? Please Describe: Puppy/Dog and General Information: Specific Puppy of Interest: Color Preference (if any): Gender Male Female No Preference Do you currently, or have you owned a Great Dane before: * Yes No Are you familiar with this breed and its required care: * Yes No Have you read our House of Danes Puppy Contract and Health Guarantee? * Yes No Are you a Breeder or have you bred animals before? * Yes No Do you have intentions to breed? * Yes No Who is your Vet? * First Name Last Name Do we have permission to contact them * Yes No Vet's Phone Number *  - Area Code Phone Number Vet's Address: Have you or anyone in your household ever been convicted of animal cruelty, neglect or abandonment? * Yes No Have you ever had to give up a pet or surrender a pet to an animal shelter? * Yes No If so, Please Explain: Have you ever been convicted of a felony or misdemeanor? * Yes No If so, Please Explain: Where did you hear about us? Questions/Comments: By filling out this application, I am authorizing you to do a background and reference check. Submit Form   Print Form Should be Empty:

House of Danes
Great Dane Puppy Application