Adoption Application - One Dane at a Time

Contact Information

Name*

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Full Name*

Occupation*

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

How long at this address?*

Daytime Phone*

Evening Phone

Best time to call*

Email address*

Family & Housing

Do you have experience with Great Danes?*

ie, a Great Dane you have owned and cared for as an adult. Choose No if you grew up with danes but have not owned one as an adult.

Yes
No

How many adults are there in your family (their relationship to you)?*

How many children (ages)?*

What type of home do you live in?*

Please explain*

Please describe your household.*

Active
Quiet
Noisy
Average

Do you rent?*

Own
Rent

Please give the rules governing pets.*

Landlord's Name*

Landlord's Phone Number*

By providing this information you are allowing ODAAT to contact your landlord. Please inform them of this call so they will speak with us.

Does anyone in the family have a known allergy to dogs?*

Yes
No

Is everyone in agreement with the decision to adopt a dog?*

Yes
No

Do you have time to provide adequate love and attention?*

Yes
No

Other Pets

What other pets do you have (specify breed and age)?*

Are these pets up to date on vaccines?*

Yes
No
Not Applicable

Are these pets spayed/neutered?*

Yes
No
Not Applicable

Why not?*

Have you ever surrendered a pet?*

Yes
No

Please explain.*

Have you ever had a pet euthanized?*

Yes
No

Please explain.*

Have you ever lost a pet to an accident?*

Yes
No

Please explain.*

How do you discipline your pets and why?*

Veterinarian

Do you have a regular veterinarian?*

Yes
No

Veterinarian’s name*

Clinic Name

Clinic Address*

Street Address City State ZIP Code

Clinic Phone Number*

By providing ODAAT with this information you are allowing ODAAT to call your vet. Please call your vet and authorize the release of information to us.

About the Dog You Wish to Adopt

Is there a particular ODAAT dog you're interested in adopting?

See our list of available Great Danes here.

What is your idea of an ideal dog and why?*

Desired age*

Desired Size*

Desired breed*

Breed you would not adopt*

Desired sex*

Spayed Female
Neutered Male
No Preference

Willing to adopt...*

outgoing/hyper dog
shy dog
dog that needs regular medication
dog that needs training
dog that needs grooming
none of these

Where will the dog spend the day? (describe)*

Where will the dog spend the night? (describe)*

Number of hours (average) dog will spend alone?*

Who will have primary responsibility for this dog's daily care?*

Who will have financial responsibility for this dog?*

Do you agree to provide regular health care by a Licensed Veterinarian?*

Yes
No

Do you agree to keep the dog as an indoor dog?*

Yes
No

When the dog goes out, how do you plan to supervise it? Fenced yard?*

Do you agree to contact ODAAT if you can no longer keep this dog?*

Yes
No

Are you be willing to let a representative of ODAAT visit your home by appointment?*

Yes
No

How did you hear about ODAAT?*

Would you be interested in fostering?*

Yes
No
Would like to know more

Personal References

Please list someone who is familiar with both you and your pets.

Reference #1 Name*

Reference #1 Address*

Street Address City State ZIP Code

Reference #1 Phone Number*

Reference #1 Relationship (relative, neighbor, friend, etc.)*

Reference #2 Name*

Reference #2 Address*

Street Address City State ZIP Code

Reference #2 Phone Number*

Reference #2 Relationship (relative, neighbor, friend, etc.)*

All of the information I have given is true and complete. This dog will reside in my home as a pet. I will provide it with quality dog food, plenty of fresh water, indoor shelter, affection, annual physical examination and vaccinations under the supervision of a licensed veterinarian. In the event that I must rehome the dog, I fully understand that the dog MUST be returned to ODAAT or legal action will be taken.

All dogs come fully vetted, vaccinated, microchipped and spayed/neutered.

Electronic Signature*

Today's Date*

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