Connecting Great Danes to Great People.
GDRST ADOPTION APPLICATION There is a $25 application fee. This fee will go towards the adoption fee if adoption is completed within 30 days of application. Please realize it may take 1 - 7 days to process your application. (GDRST adopts only to the greater Houston, TX area) ALL potential adopters are screened for suitable placements of animals. Great Dane Rescue of Southeast Texas may refuse placement of an animal for any reason. By submitting this application, you give permission for Great Dane Rescue of Southeast Texas to investigate and confirm the information that you provide. All forms become the property of Great Dane Rescue of Southeast Texas upon submission. All fields are required. If you find that one does not pertain to you then please put NA.
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Release for Veterinary Reference: (required)
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 Southeast Texas. (digital signature)
My current veterinarian is
Veterinarian Address:
Veterinarian Phone:
Full Name:
DL#:
DOB:
E-mail address:
Home Phone:
Cell Phone:
Street Address:
City, State & Zip:
Employer Name:
Work Address:
Work Phone:
Spouse's Name:
Spouse's Employer:
Spouse's Work Phone:
I live in: ---houseapartmentmobile homecondo other:
Number of adults in household?
Number of children in household?
Children's Ages:
Do you anticipate having children as members of your family/household within the next 8 years? 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 adopting? yes no
Are you or your spouse a student? yes no - If yes, full time part time
Do you or your spouse travel frequently? 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? yes no
If so, who & what are the concerns
Does anyone living in the house have allergies to dogs? yes no
Does anyone have asthma? yes no
Do you have an enclosed fenced yard? yes no - Type: ---woodchain linkwrought ironcattle fencing other:
Height of shortest side? (in feet)
How long at current address? years months
Do you own your own home? yes no
Do you plan to move in the next 12 months? 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? yes no
Is a pet deposit required? yes no How much? per pet per household
Size/Weight limit? yes no Limit:
Can proof of deposit be obtained from your landlord? yes no
Name of Apartment Complex or Landlord:
Apartment Complex or Landlord phone number:
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This pet will be kept: ---mostly insidemostly outsidetotally insidetotally 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? yes no
Are you willing/able to purchase and use a cage/crate if needed or advised? yes no
Do you have a pet door? yes no
How will you teach housebreaking?
Who are you getting this animal for?
Have you ever owned a Great Dane or giant breed dog before?
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?
Puppy Agreement
Proof of spay/neuter must be provided to GDRST before the dog is 9 months old. Failure to spay/neuter will result in the repossession of the dog. I agree (digital signature) Date
All puppy shots will be the sole responsibility of the new owner, and proof of these shots must be provided to GDRST at the designated time frames - 6 weeks, 12 weeks, and 6 months or as prescribed by your vet. I agree (digital signature) Date
Heartworm medication will be given monthly to the dog as prescribed by your vet. I agree (digital signature) Date
PET OWNERSHIP HISTORY
Have you ever adopted from a humane group or shelter? 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? yes no - If so, why?
What did you do with the animal?
Explain 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 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? yes no no pets
Date of last vaccinations?
Are all of your dogs on heartworm preventative? yes no no dogs
What kind of preventative?
What is the last date of heartworm preventative given?
Has your dogs received a Bordatella (kennel cough) Vaccine? yes no
What is the last date of the Bordatella Vaccine given?
Have any pets in your household been diagnosed with infectious diseases or conditions? Heartworms yes no
Distemper yes no
Parvovirus yes no
Please list all pets currently owned or owned within the last five years.
*If current pet is a mixed breed dog, please indicate size of pet (small/medium/large).
Pet's name: *Breed: male female Age: Length of ownership: Was it spayed/neutered? yes no If no, why not? This pet was kept: ---mostly insidemostly outsidetotally insidetotally outside
Please rate the following issues/traits per their importance in your adopted pet: P-Preferred A-Acceptable R-Required N-Not acceptable/will not accept
Needs obedience training P A R N
Good with other large dogs P A R N
Good with children of all ages P A R N
Good with cats P A R N
Already crate trained P A R N
Needs housebreaking work P A R N
Good with other dogs of all sizes P A R N
Has fear of storms P A R N
Timid with new people P A R N
PREFERENCES
Do you have a preference of sex? ---No preferencemalefemale
Do you have an age preference? ---No preferenceunder 6 months6 mos - 1 yr1 - 3 yrs4 - 6 yrssenior
Which of the above are requirements (you will not consider any Dane except one that meets this specification)? ---no requirementssexageboth sex & age Reason:
Would you be willing to adopt a Dane with special needs? yes no If yes, which special needs would you consider? ---Needs surgeryNeeds ongoing medicationsBlindDeafAny of the aboveOther
Would you consider adopting a Great Dane mix? 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.)
Are you currently working with another rescue group to adopt? 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 with us. Please inform us if you adopt from another group or decide not to adopt so we can mark your application inactive.)
Required Reading
Your Great Dane and You (PDF)
Stomach Torsion (PDF)
Feeding Guide (PDF)
Crate Training (PDF)
Kids and Danes (PDF)
Have you read all the contents of the required reading that has been provided to you by Great Dane Rescue of Southeast Texas? yes no If no, why not?
Have you done other research into the Great Dane breed? yes no If yes, where did you obtain information?
How did you find Great Dane Rescue of Southeast Texas? ---Internet searchNewspaper adFriend/Family referralWalk up to a Meet & Greet Event other:
Is there a Dane in our program that you are currently interested in?
Great Dane Rescue of Southeast Texas 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 Southeast 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? yes no
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 Southeast Texas.
Applicant Signature (digital signature)
Date:
