Instructions: Please read this Application, fill in the blanks, sign it, and return it to us at the address above. The information you provide in this Application and during our interview will help us find a good match for you.
Type of Dwelling
Do you own or rent your home*
If you rent, please enter your landlord's name and phone number*
How long have you lived here?*
What type of fence
Is your yard fenced*
Yard Partially Fenced
Yard Completely Fenced
What is the height of the fence*
You are aware that your Great Dane MUST be kept on a leash at ALL TIMES when not in a fenced area Please initial *
you must keep a collar BEARING IDENTIFICATION AND VACCINATION TAGS , on your Great Dane at all times, and further, notify Pennsylvania Great Dane Rescue and Rehab immediately if a dog should ever become lost (Please initial) *
Great Danes MUST LIVE WITHIN THE HOME . They CANNOT LIVE outdoors in a kennel or dog house, be chained up, put on a wire run or be kept outside in any fashion on a permanent basis. You agree to keep your new pet inside your home. (Please Initial)
If "NO" you how many hours a day hours a day will the Great Dane be left alone?*
Is there a family member home during the day?
Is there a family member home during the day?
Where will he/she sleep at night?
Where will the dog be kept when you are not home? (CHECK ALL THAT APPLY)
Number of adults including yourself?*
Do you have any children including any who visit regularly or on a frequent basis?
If "YES" please list how many ages and gender
Does anyone in your household have allergies?
Are other household members enthusiastic about adopting a Great Dane?
Who will be primarily responsible for the care of this dog?*
Do you currently have other pets?
*If "YES" list how many dogs , cats, or other types pets, sex, age , are they altered?*
What pets have you had in the past and what happened to them*
Vet Information please list ALL vets you use currently or have in the past*
What happened to them?*
Are you familiar with the health problems with this breed? (i.e. short life span, bloat, gastric torsion, hip/elbow dysplasia
Why do you want a Great Dane?
Are you aware and prepared for , the financial responsibility of owning a "GIANT' breed? (Food costs, licensing, routine vat care)
How did you hear about or who referred you tp Pennsylvania Great Dane Rescue and Rehab?*
Why did you decide to adopt rather than purchase a puppy?
Dogs adopted through Pennsylvania Great Dane Rescue come to their new owners already
Dogs adopted through Pennsylvania Great Dane Rescue come to their new owners alreadyspayed/neutered, with inoculations current within six months, initial worming, flea treatment and a heart worm check. In exchange for these medical services/ and to help defray our group’s expenses, there is an ADOPTION DONATION, which IS NON-REFUNDABLE.*
A premise inspection/home evaluation, conducted by Pennsylvania Great Dane Rescue representative(s) is required. When would the most convenient day and time be for you? *
You understand that your ownership of this Great Dane will be subject to the conditions set forth in this application, and that if the dog is judged to be kept in an unacceptable fashion by Pennsylvania Great Dane Rescue, or any portion of this application has been falsified, Pennsylvania Great Dane Rescue is entitled to regain ownership of the dog. By initialing I agree *
You take full responsibility for any future liability concerning this dog, once you have taken custody. This includes any type of vet care as well as any dog bites or injury that has occurred from the dog adopted by the new adopting party and can not hold Pennsylvania Great Dane Rescue, Inc. responsible in anyway. *
Should you be unable to care for any dog you adopt from the Pennsylvania Great Dane Rescue, you agree that you will return the dog to the Pennsylvania Great Dane Rescue. *
**Refusal of 6 month home check and evaluation will result in automatic denial of application and if a dog has been adopted to you and your refuse the 6 month after adoption home check a local dog law enforcement officer and a PGDR representative will come your home anyhow to ensure that the dog is safe and in humane conditions, which can result in confiscation of the dog, non refunded adoption fee and denial of further adoptions with PGDR. *
The Applicant(s), including all adults in the household, agree that this is a CONTRACT entered into with Pennsylvania Great Dane Rescue and, as such, is binding. I/We hereby certify that all the information contained on this ADOPTION APPLICATION is true and correct to the best of my/our knowledge and I/We agree to the terms specified herein:
Sign and Date*