Victory Danes Puppy Application
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary Phone Number
*
Please enter a valid phone number.
Secondary Phone Number
Please enter a valid phone number.
Email
*
example@example.com
Type of Residence
*
House
Apartment
Condo/Townhouse
Mobile Home
How long at present address?
*
Do you:
*
Own
Rent
If renting, provide landlords name & phone number:
Please list name and age of everyone living in the household, including yourself:
*
Is everyone in agreement to purchasing a great dane?
*
YES
NO
Is anyone is the household allergic to animals?
*
YES
NO
Do you have plans to move in the near future?
*
YES
NO
If you did move, what would you do with your animals?
*
Is your home fenced?
*
YES
NO
What type of fencing?
*
Wood
Chain Link
Vinyl
Other
How tall is the fence?
*
4 Feet
6 Feet
8 Feet
None
Do you have a pool?
*
YES
NO
Pleas describe the neighborhood you live in. Ex: town or country, quiet or busy, major roads; traffic, are they lots of children, dogs, etc.
*
Please list all the animals you currently own by breed/gender/short description of pets personalities and temperament.
*
Are all your pets spayed & neutered?
*
YES
NO
If no, please explain why:
*
N/A if yes
How many pets have you had in the last 10 years?
*
Where are those pets now?
*
Are you a breeder or interested in breeding?
*
YES
NO
If yes, please summarize your breeding program:
*
N/A if NO
Have you ever adopted a pet before?
*
YES
NO
If yes, who did you adopt through?
*
N/A if NO
Why do you want a Great Dane?
*
Are you willing and able to properly train/socialize a Great Dane puppy/Dog?
*
What is your experience with Great Danes?
*
Who would be responsible for your puppy's daily care?
*
How many hours a day would your puppy be left alone?
*
Where will the puppy stay when alone?
*
Where will the puppy stay at night?
*
How active is your family?
*
Very Active
Somewhat Active
Not Very Active
Couch Potatoes
Will the puppy be included in family activities?
*
YES
NO
Does your family participate in water activities?
*
YES
NO
Where will the puppy stay during family trips/vacations?
*
Current Vets Name:
*
Current Vets Phone Number:
*
Current Vet Address:
*
What do you believe an average yearly cost for medical care to be?
*
What do you believe an average yearly cost would be to feed a great dane?
*
What will you feed your puppy?
*
How will you exercise your puppy?
*
Do you have a preference in gender?
*
Male
Female
Either
Color preference?
*
Please provide two personal references (Name and Phone Number):
*
Any other comments or information you would like us to know in considering your adoption application?
By signing this form, I hereby certify that all the information provided by me is true and complete. I understand that any misrepresentation of information may result in adopted animal being confiscated.
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