Great Dane Rescue of North Texas - Adoption Application

Foster Home Application

Please check this box if this is an application to be a foster home.

Release for Veterinary Reference:

PLEASE FILL OUT ALL INFORMATION IN THE VETERINARY RELEASE BOX BELOW. APPLICATION CANNOT BE PROCESSED WITHOUT THE INFORMATION:

I hereby give permission for any veterinarian providing service to me to release medical information on any/all of my animals to Great Dane Rescue of North Texas.

Veteriniarian Used: Phone Number:

Personal Information:

Full Name:

Drivers License Number: State: Choose state... Alaska Alabama Arkansas American Samoa Arizona California Colorado Connecticut District Of Columbia Delaware Florida Georgia Guam Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Virgin Islands Vermont Washington Wisconsin Wisconsin West Virginia Wyoming Wyoming
Date of Birth: E-Mail:

Address:
City: State: Choose state... Alaska Alabama Arkansas American Samoa Arizona California Colorado Connecticut District Of Columbia Delaware Florida Georgia Guam Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Virgin Islands Vermont Washington Wisconsin Wisconsin West Virginia Wyoming Wyoming Zip Code:

Home Phone: Mobile Phone: Work Phone:

Employer Name and Address:

Spouse Name: Spouse Employer: Work Phone:

I live in a: Choose one... House Apartment Mobile Home Condo Other...

Number of adults in household: Number of children in household and the ages:

Do you anticipate having children as members of your family/household within the next 8 years? Choose One... Yes No

How often will your dog come into contact with children (close neighbors, grandchildren, etc.)?

How old are those children?

Do ALL of the adults in the household consent to this adoption? Choose One... Yes No

Are you or your spouse a student? Choose One... Yes No If yes, full time or part time: Choose One... Full-Time Part-Time Not a Student

Do you or your spouse travel frequently? Choose One... Yes No If yes, how often?

What will you do with this pet when you need to travel?

Does anyone have any concerns about adopting this pet? Choose One... Yes No
If so who and what are the concerns

Does anyone living in the house have allergies to dogs? Choose One... Yes No Does anyone have asthma? Choose One... Yes No

Do you have an enclosed fenced yard? Choose One... Yes No Type: Choose One... Wood Chainlink Rod Iron Cattle Fencing Other...

Height of shortest side? ft

How long at current address? years months Do you own your home? Choose One... Yes No

Do you plan to move in the next 12 months? Choose One... Yes No If yes, where:

What will you do with this pet if you have to move?

How many times have you moved in the past 10 years?

If you rent

Does your landlord allow pets? Choose One... Yes No Is a pet deposit required? Choose One... Yes No

How much? $ Choose One... Per Pet Per Household Size/Weight limit? Choose One... Yes No Limit: lbs.

Can proof of deposit be obtained from your landlord? Choose One... Yes No

Name of Apartment Complex or Landlord:
Phone number (required):

Pet Care at Home

This pet will be kept: Choose One... Totally Inside Mostly Inside Mostly Outside Totally Outside

How long will this pet be left home alone during the day?hrs x days/week

Where will this pet be kept while you are at work or away from home?

Where will this pet sleep at night?

Are you willing/able to complete obedience classes with this dog if needed or advised? Choose One... Yes No Not Sure

Are you willing/able to purchase and use a cage/crate if needed or advised? Choose One... Yes No Not Sure

Do you have a pet door? Choose One... Yes No

How will you teach housebreaking?

Who are you getting this animal for? Choose One... Self Gift For...

Have you ever owned a Great Dane or giant breed dog before? Choose One... Yes No
Details:

Why would you like to add a dog to your family at this time?

What qualities are you looking for in the dog that you would like to adopt? Be very specific (very active vs. couch potato; want to do obedience work/agility/flyball; interested in therapy certification, etc) so that we can make the best match.

What do you expect to be the worst and/or hardest part about adopting a rescued dog, and how do you plan to address it?

What do you consider an acceptable adjustment period for your adopted pets and the pets already in your home?

Pet Ownership History

Have you ever adopted from a humane group or shelter? Choose One... Yes No

If yes, who did you adopt from: When?

Have you ever given an animal up for adoption or gotten rid of an animal? Choose One... Yes No

If so, why?

What did you do with the animal?

Explain (continue on the back of this sheet if needed) what efforts/steps you made to keep the pet prior to deciding to find it a new home (i.e. Did you consult a professional? If so, who and what did they recommend? How long did you try to work on the problem? How did you find your pet a new home?)

Are all the pets in your household current on their shots? Choose One... Yes No No Pets Date of last vaccinations?

Are all your dogs on heartworm preventive? Choose One... Yes No No Dogs What kind of preventive?

What is the date of last heartworm preventive given?

Have any pets in your household been diagnosed with infectious diseases or conditions?

Heartworms Choose One... Yes No Distemper Choose One... Yes No Parvovirus Choose One... Yes No

Please list all pets currently owned or owned within the last five years (use back if you need more room):

*If current pet is a mixed breed dog, please indicate size of pet (small/medium/large).

1. Choose One... Dog Cat *Breed: Choose One... Male Female Age: Length of ownership:

   Was it spayed/neutered? Choose One... Yes No If no, why not?

   Do you own the pet now? Choose One... Yes No If no, what happened to it?

   This pet was kept: Choose One... Totally Inside Mostly Inside Mostly Outside Totally Outside

2. Choose One... Dog Cat *Breed: Choose One... Male Female Age: Length of ownership:

   Was it spayed/neutered? Choose One... Yes No If no, why not?

   Do you own the pet now? Choose One... Yes No If no, what happened to it?

   This pet was kept: Choose One... Totally Inside Mostly Inside Mostly Outside Totally Outside

3. Choose One... Dog Cat *Breed: Choose One... Male Female Age: Length of ownership:

   Was it spayed/neutered? Choose One... Yes No If no, why not?

   Do you own the pet now? Choose One... Yes No If no, what happened to it?

   This pet was kept: Choose One... Totally Inside Mostly Inside Mostly Outside Totally Outside

Please list additional pets, if appropriate:

Traits

Please rate the following issues/traits per their importance in your adopted pet:
Choose One... Preferred Acceptable Required Not Acceptable/Will Not Accept Needs Obedience Training
Choose One... Preferred Acceptable Required Not Acceptable/Will Not Accept Good with cats
Choose One... Preferred Acceptable Required Not Acceptable/Will Not Accept Good with other dogs of all sizes
Choose One... Preferred Acceptable Required Not Acceptable/Will Not Accept Good with other large dogs
Choose One... Preferred Acceptable Required Not Acceptable/Will Not Accept Already crate trained
Choose One... Preferred Acceptable Required Not Acceptable/Will Not Accept Has Fear of Storms
Choose One... Preferred Acceptable Required Not Acceptable/Will Not Accept Good with children of all ages
Choose One... Preferred Acceptable Required Not Acceptable/Will Not Accept Needs housebreaking work
Choose One... Preferred Acceptable Required Not Acceptable/Will Not Accept Timid with new people

Preferences

Do you have a preference of sex? Choose One... No Preference Male Female

Do you have an age preference: Choose One... No Age Preference Under 6 Months 6mos-1yr 1-3 yrs 4-6 yrs Senior

Which of the above are requirements (you will not consider any Dane except one that meets this specification)?

Would you be willing to adopt a Dane with special needs? Choose One... Yes No

If yes, which special needs would you consider? (control-click to select more than one)
Needs surgery Needs ongoing medications Blind Deaf Other Not Applicable

Would you consider adopting a Great Dane mix? Choose One... Yes No

When will you be ready to adopt? DATE YOU ARE READY TO ADOPT/TAKE HOME A DANE:

(Please note that if you are not ready to adopt within one month, your application will be partially processed and then temporarily filed. Your home visit & vet reference check will be performed 2-4 weeks prior to your being ready to adopt.)

If you reside outside of North Texas, are you willing and able to travel to Dallas/Fort Worth to meet and adopt? Choose One... Yes No

When are you able to make the trip? DATES AVAILABLE TO TRAVEL TO ADOPT:

Are you currently working with another rescue group to adopt? Choose One... Yes No
If yes, which group?

(Note: Please inform us if you decide to work with another group in addition to ours after you apply to us. Please inform us if you adopt from another group or decide not to adopt so we can mark your application inactive.)

Have you read all the contents of the information booklet that has been provided to you by GDRNT or the online brochure in the "How To Adopt" section on our website? Choose One... Yes No

If no, why not?

Have you done other research into the Great Dane breed? Choose One... Yes No

If yes, where did you obtain the information?

How did you find Great Dane Rescue of North Texas?

Choose One... Internet Search Newspaper Ad Friend or Family Referral Walk up to Meet & Greet Event Other... Details:

GDRNT offers a special program for senior citizens and those needing an extra hand with pet care. Please check here if you are interested in learning more about our Seniors for Seniors program and how to qualify.

Do you give permission for a Great Dane Rescue of North Texas representative to visit your home prior to adoption to do a home check and after adoption to do follow up checks on your adopted pet? Choose One... Yes No

How have you paid your application-processing fee? Choose One... PayPal Check Cash at a Meet & Greet Event Other... Details:

I confirm that all the information in this application is correct and complete to the best of my knowledge. I understand that any false or misrepresentation of information discovered either now or in the future will cause my application to be denied. I also confirm that I have read all contents of the information booklet provided by Great Dane Rescue of North Texas.