Name:
Street Address:
City: State/Province:
Zip/Postal Code: Country:
Home Phone:
Cell Phone 1: Name:
Cell Phone 2: Name:
E-Mail:
Number of adults in household: Ages:
Number of children in household: Ages:
Does anyone in the household have allergies to dogs?
If yes, please explain:
Why do you want a Great Dane?
When are you looking to purchase a puppy?
Is everyone in the household committed to getting a Great Dane?
If no, please explain:
Who will be the primary caregiver?
Are you familiar with the characteristics, temperament and health related problems in the Great Dane?
Do you have other animals?
If yes, please explain what kind of animals you have now:
Are your other animals spayed or neutered?
If you do not have other dogs now, have you had other dogs in the past?
If yes, please explain what breeds and happened to them:
Have you ever shown a dog in conformation?
Have you ever shown a dog in obedience?
Have you ever done any obedience training with dogs?
What traits are you looking for in this puppy?
What sex do you prefer?
If your preference for male or female is not available, would you consider the other sex?
If not, why not?
Do you want your puppy's ears cropped?
What activities do you intend to pursue with this puppy? (check all that apply)
If you checked Assistance or Therapy Dog or Other, please explain:
How do you plan to get the puppy to you?
If you selected "ship" or "other", please explain:
Do you have a fenced yard or enclosure?
If yes, please describe the type and height of the fencing:
If no, please explain how you plan to control your dog:
How many hours per day will the dog be left alone?
If more than six hours, will there be a lunch walk?
If yes, by whom?
How much exercise will this dog have each day?
Where will the dog primarily spend its time?
Where will the dog sleep at night?
Where will the dog be when no one is at home?
Where will the dog be when you are on vacation?
Please provide the names and phone numbers of two people who will know how to contact you:
Please provide the name and phone number of the vet you most often use:
Who referred you to Dane Affaire?
Are there any foreseeable changes to the responses above in the near future?
Is there anthing else that may be pertinent to getting a Great Dane puppy?
Is there anything else you want to add about the life the dog will be living?