Great Dane Rescue
1930 W 35th Street
Steger, IL 60475
FAX-775-659-2387
The Plantation Animal Rescue reserves the right to refuse adoption to anyone. No animals will be adopted to prospective owners who mislead or fail to provide accurate information on the adoption application. Please type your information at the end of each question line in the application. Please be sure to answer ALL of the following categories and sections completely. An incomplete application will not be considered. You may also add an additional narrative page if you desire. Send your completed application to The Plantation Animal Rescue in one of the following ways:
1.By e-mail to: greatdanerescue@ameritech.net
2.By FAX to (775)659-2387
3.By mail to 1930 W 35th Street, Steger, IL 60475
Today’s date:
Full name(s) of applicants:
Your complete address (street, city, state, and zip; also include P.O. Box if you receive mail by PO
In case we need to contact you, please give your
Home phone number:
Work phone number
Cell phone number:
Your E-mail address:
Your Date of Birth:
Drivers License Number:
Are you inquiring about a particular dog? (Please state which one or ones)
ii.What sex would you consider? (male, female, or “any”)
iii.What age category are you interested in?
Are you familiar with the Great Dane breed, and its general traits and characteristics?
If yes, how?
Give an example of the actual size you are looking for.
How long have you been looking for a dog?
Is this your first pet? Yes No
Is this your first Dane? Yes No
YOUR HOME:
Do you live in a home, apartment, mobile home, duplex, or condo?
Please describe your home:
How long have you lived there?
Do you rent/lease or own your own home?
If you rent, does your lease allow pets? Yes____ No ____
If you rent, what is your landlord’s name? __________________________
Phone: ______________________________
If you move in the future, what will you do with your pets?
What would you do with them if you couldn’t take them with you?
YOUR HOUSEHOLD:
List all the members of your household and include their names, ages and relationship.
Do all the members of your household know that you are trying to adopt a dog and agree with it?
Do you run a daycare in your home, or do at-home baby-sitting for others?
YOUR RESTRICTIONS:
Are you aware of your township’s/city’s restrictions and regulations regarding dogs, and agree to abide by those restrictions and regulations?
How many dogs can you legally have on your property?
Place of Employment:
Address:
Phone: Ext:
Drivers License#
State:
Date of Birth:
Spouse’s Name:
Spouse’s Employer:
Address:
Phone: Ext:
Drivers License#
State
Date of Birth:
How did you hear about us? I looked on the internet for great dane rescue.
Petsmart___Internet___Newspaper____Friend____Breeder___Other______
YOUR PETS:
List every pet you currently own. Please include their type/breed, age, size, and how long you have had them and where they are kept
Name Breed Age/Size How long owned Kept where
1.
2.
3.
4.
5.
6.
Are all of your pets up-to-date on shots and vaccinations?
Rabies
DHLPPC
Heartworm Preventative?_____ 6 or 12 months?____________ What Brand? Heart Guard
Have they been spayed or neutered? If not, please explain why
Did you have any other pets in the past 10 years?
What kind?
What happened to them? Exactly!!
What problems have you experienced with your pets, and how did you handle them?
Have you ever given away a pet?
Veterinarian where your pet(s) records are located:
Please include vet’s name:
Clinic name
City, State, Zip:
Telephone number, including area code:
YOU MUST GIVE THIS VET PERMISSION TO RELEASE YOUR PET’S MEDICAL HISTORY. This is a mandatory reference for this rescue. If you do not have a veterinarian, and you are a previous pet owner, explain why not. If you have never been a pet owner, state that, and please supply the information on the veterinarian that you would use.
How many adults live in your household? ______
_
How many children? _______
Do all the adults know that you plan to adopt? ___________
If there are children in the household, what are their ages?
______ ______ _______ ______ _______ ______ ______
Do you, or does anyone living in your household have any known allergies to
animals? Yes_____ No_____. If yes, to what kinds of animals, and how severe is the allergy
Who will be responsible for the care of this pet?
Where will this pet be kept during the day?
Where will this pet be kept during the Night?
How many hours will it spend alone without human companionship?
Where will it be kept when alone:
DOG ADOPTIONS ONLY:
Do you want the dog for a (check all that apply)
house pet ____
guard dog_____
Watch dog____
companion___
gift_____
companion for another pet_______
Hunting________
obedience/agility___________
therapy______
other______
Do you have a fenced yard? Yes_____No_______
If yes, how high.________
What kind of fence is it? (board, chain link, etc.):
How will you keep your dog confined to your property?
In house____
patio___
kennel_____
fenced yard_____
on chain_____
garage_____
on leash_______
List 3 Personal references with Phone numbers (NO RELATIVES OR WORK NUMBERS)
1)____________________________________________
2)_____________________________________________
3) ___________________________________________
Have you ever applied to adopt from a Rescue
or Humane Society to adopt a dog or cat before?
Results?
What organization?
YOUR OCCUPATION AND FREE TIME:
Please state your occupation and your spouse’s occupation:
Approximately how many hours each day would your dog be alone? (i.e.: none, 1-3 hours, 4-6 hours, 7-9 hours, 10 or more hours).
Where would the dog be kept when it is alone?
How long would your dog be left alone outside when you are at home?
How long would your dog be left alone outside when you are not at home.
Do you plan on taking your dog to obedience training classes? Yes___No____
If No, what method will you use to train your Dane?
To facilitate the bonding process, we recommend every
dog owner attend some introductory obedience
training. Are you willing to participate in a formal
obedience training program? ______
If not, please provide a brief explanation:
If No, what method will you use to train your Dane?
How much time and effort do you want to devote to training your dog?
What would be your response if your dog made a
mistake?
What is your initial reaction to the idea of
disciplining your dog?
What is your definition of disciplining a dog?
If everyone in the household works during the day,
where will the dog spend its time?
Do you realize that Great Danes shed ?___________
Are you able to exercise your Great Dane?_________________________________
What methods will you use to exercise your Great Dane?_____________________________________________________________________________
Are you aware a bored Dane will chew?_____________________________
Do you have a vehicle that can hold a Great Dane? ________________
Are you familiar with Bloat/Torsion? _________
Are you familiar with crating a dog?
Are you financially able to care for a new pet? (feeding, routine vet care:
Vaccinations, parasite checks, emergency vet care, licensing, etc.) Yes___ No___
How will you provide for your dog when you must go out of town or on vacation
Are you willing to take responsibility for this dog for the rest of its life?
Can you: Make this commitment for the many years this dog could live? (10-12 years)
THE “NEW” DOG:
It can take a couple of weeks to a month for a new dog to adjust to its new home and your routine.
Are you prepared to be “understanding” during this time period?
What concerns do you have about this adjustment period?
It is not uncommon for a dog to have “potty accidents” when it changes its “home”, routine, and human “family” for as much as 3 or 4 weeks. It will be confused, and confronted by all new people, routines, surroundings, and expectations. If your new dog has an “accident”, how would you deal with it?
What form of discipline would you use with the rescue dog, if you become its adoptive family?
Do you understand that if for any reason you can no longer keep the dog, that you are responsible for, and bound by, the adoption contract to return it to this rescue?
The proper care of the adopted dog is a priority. Do you understand that it would be your responsibility to keep the dog up-to-date with vaccinations, check-ups, heartworm preventative, and necessary treatments should you become the adoptive family?
Not to do so, would result in a breach of contract.
Should you become the adoptive family for one of our rescue dogs, we ask that you keep in contact with us periodically during the first year to let us know how things are going. We appreciate knowing how the dogs are doing, and also in receiving photos and “happy adoption”/”happy ending” letters to share with others. Would you agree to this?
ADDITIONAL COMMENTS I WOULD LIKE TO MAKE
Signature: ________________________________________
I agree to provide adequate food, shelter, water, medical treatment and humane treatment at all times.
I understand that The Plantation Animal Rescue reserves the right to investigate the care, treatment and environment of adopted animals at any time, and has the right to immediately remove any animal adopted through them, if they feel it's in the best interest of the animal. Adoption fees will not be refunded after a period of 2 weeks.
VERIFICATION:
I hereby state that I have thoroughly read and understood the adoption process through The Plantation Animal Rescue, and furthermore, by submitting my application:
I attest that I have carefully read and completed all of the questions.
I agree to its conditions.
I understand that falsification of any of the information will be grounds to disallow my application from any dog from The Plantation Animal Rescue.
By filling in my name below, I hereby give The Plantation Animal Rescue permission and authority to process my application and investigate the statements made in this application.
By signing or typing my name below, I give The Plantation Animal Rescue permission and authority to process my application and contact my references
.
Upon adoption, The Plantation Animal Rescue relinquishes all responsibility of the adopted pet to the new adoptive owner. The Plantation Animal Rescue will not be held liable for any personal liabilities or damage to property or financial indebtedness incurred for the care of the adopted animal after adoption.
Signature_______________________________ Date_______________________
Do not write below this line
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Adoption reviewed by _________________ Animal adopted__________________
Landlord approved_____________________Donation/Adoption fee $___________
Residence check (drivers license) _____________Vet reference__________________
Approval________________________________________________________
Restrictions______________________________________________________
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