Adoption Application Adoption Application If you are human, leave this field blank. Your Name * First and Last Spouses Name First and Last Street Address * City * State * Zip * Mailing Address (if different than street address) City State Telephone Number * Best number to reach you, perferabley cell Zip Email Address * Best Time To Reach you: (check all that apply) * Day Evening Weekends Why do you want to adopt a Great Dane? * Have you ever owned a Great Dane before? * Yes No If no, Are you willing to visit the home of a local Dane owner or have one of our Danes come to your home for a visit? Yes No Have you been to the Great Dane Club of America's website (www.GDCA.org) and done your research on the breed? * Yes No Are you aware the Great Danes drool, dig, lean, fart, shed, knock things over with their tails, chase squirrels, run madly from one end of the house to the other when excited, can take things off of counters, sit on your lap, and like to drink from the sink? * Yes No What age of a Great Dane are you looking for? (check all that apply) * Puppy 1-2 Years 2-5 Years 5-8+ Years Are you interested in a: (check all that apply) * Male Female What Color are you most interested in? * What ear style do you prefer? (check all that apply) * Natural Cropped Of the above preferences, would you be willing to accept a suitable dog of another: (check all that apply) * Age Sex Color None Would you consider a: (check all that apply) Dane Mix Senior Disabled Blind Deaf On Medication Needs Training Is there a particular Dane at NWGDR that you are interested in? Are you aware of the costs of owning a Great Dane? * Yes No Have you ever obedience trained a dog through classes? * Yes No Will you take your new Great Dane to obedience classes? * Yes No What kind of activities do you pan to do with your dog? (check all that apply) * Family Pet Obedience Rally Agility Jogging Therapy Guard/watch dog Do you have any other animals? If yes, list below: * Yes No 1-Name Age Breed/Species Male/Female 2-Name Age Breed/Species Male/Female 3-Name Age Breed/Species Male/Female 4-Name Age Breed/Species Male/Female Other (exotic/livestock) Are your current pets spayed/neutered? * Yes No If no, why not? Please tell us about any dogs you have owned in the last 5 years and why you no longer have them: (if not applicable, put n/a) * Have you ever had to re-home and animal and why? (if not applicable, put n/a) * Are there more living in your house than listed above? If yes, plase list below: * Yes No Name Relationship Age (if under 18) Name Relationship Age (if under 18) Name Relationship Age (if under 18) Name Relationship Age (if under 18) Does everyone in your home agree on bringing a Great Dane into your household? * Yes No Please describe any other visitors to you home that the Great Dane must get along with (human or animal) * Please describe your home: (house/apartment/number of floors, etc...) * Do you own or rent your home? * Own Rent If renting, does your rental agreement permit you to keep pets? Landlord's name and phone number (if applicable): How long have you lived in your home? * Do you have a fenced yard? * Yes No If yes, please describe the fencing and how tall: If no, how do you plan to exercise and potty your dog? Is anyone in your home during the day? * Yes No Occasionally How many hours a day will the Great Dane be left alone? * Where will you keep your Great Dane during the day? * Where will you keep your Great Dane at night? * Will you crate train your Great Dane if not already? * Yes No Where will you keep your Great Dane if your family is away overnight or on vacation? * Are you aware of the leash laws in your city? * Yes No Do you agree to license your Dane according to your local ordinances? * Yes No Please list the name of an INDIVIDUAL (other than relatives) who knows/has known your other animals: * Required if you want your application to be considered. Telephone Number * Please list the name of another INDIVIDUAL (other than relatives) who knows/has known your other animals: * Required if you want your application to be considered. Telphone Number * Please list the name and telephone number a VETERINARY that you most currently use for the care of your animals. * Telephone Number * May we contact the references to verify the above information? * Yes No At any time, if you are unable to keep your Dane, you are to contact NWGDR and return the dog to us. * I agree I disagree At NWGDR we are members of a local Great Dane club that promotes education about our breed, and we participate in several community events in the Spokane are. Would you like to be included in our email list? Yes No We understand that rescue dogs are not for everybody, and that they will not always fit into every household. If you decide that a rescue dog is not for you, would you like for us to put you in contact with a reputable breed that we know personally and trust to follow the Great Dane Club of America's Code of Ethics? Yes No NWGDR can only operate through donations and adoption fees. Vet expenses, travel, dog food, and other care items can add up with each and every dog we place. In order to offset some of these costs, we charge and adoption fee of $350 per dog plus we ask to be reimbursed for any veterinary charges that were incurred in the time that the dog was in our care. * I understand All the information I have given above is true and complete. NWGDR has my permission to contact individuals and veterinaries listed in the above responses. I understand that this dog will live in my home ans a pet and that it is my responsibility to provide adequate food, water, shelter, exercise, socialization, training, affection, safety and medical care for this Dane. * Initials I understand that NWGDR is not responsible for the accuracy of information received about temperament, habits, or physical condition of Danes available for adoption. I agree to meet and evaluate the dog for myself before choosing to adopt him/her. I understand and agree to these terms. * Initials By signing below (including electronic signature), you agree that NWGDR is in no way liable or responsible for any damage, accident or injury resulting from the placement of a dog into my household and I agree to indemnify and hold harmless NWGDR and it's members from any claims for damages arising from actions of a dog adopted by me. * Type Full Name Date Signed * reCAPTCHA Submit Thank you for applying to NWGDR. We will be contacting you shortly after receiving your paperwork. WE RESERVE THE RIGHT TO REFUSE AN APPLICANT FOR ANY REASON.