House of Danes Puppy Application
s
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.
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House of Danes
Great Dane Puppy Application