Kirk's Dane Farm Waiting List
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Best way to reach you: (i.e. Facebook Messenger, Text, Call, FaceTime)
Phone Number
-
Area Code
Phone Number
How did you hear about us?
What are the most important qualities you would like to find in a puppy?
What colors in the dane breed are you looking for?
Harlequin
Merle
Blue
Fawn
Black
Mantle
*Other
If *Other was selected above, please describe your color choice below.
Which would you prefer:
Male
Female
Doesn't matter
Have you ever owned a puppy/dog/dane before?
Yes
No
Are you willing to read our Puppy Contract and Health Guarantee BEFORE selecting a puppy? (A copy is found on our website under the tab "Puppy Contract & Gaurantee")
Yes
No
If a puppy is chosen, will you do the very best you can to provide a loving and safe place while instilling a well mannered dane with training and obedience?
Yes
No
If you have any questions or concerns, please list below and I will be in contact with you as soon as I can.
Submit
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