Southwest Great Dane Rescue, Inc.
is registered with the Florida Department of Consumer Services to solicit contributions.
Registration Number: CH25130
“A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE (800-435-7352) WITHIN THE STATE. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE.”
APPLICATION
*We do not adopt out of the State of Florida
You must be over 21 years old to adopt from SWGDR
I am submitting an application for:
Which dog are you interested in?:
First Name:
Last Name:
Address:
City, State & Zip:
Phone #:
Alternate#:
E-mail Address:
Re-confirm E-mail:
Marital Status:
Your Age:
Children:
Please provide the ages of your children:
*It is important to understand some dogs are not comfortable around young children, we want to find the right dog for you and your family.
How did you hear about us?
If you checked other, please tell us:
Referred by:
Your Occupation:
Employer's Name & Phone #:
This area is reserved for SWGDR use only
Co-Applicant's Information
Co-Applicant's Name:
Age:
Phone #:
Relationship to Applicant:
Co-Applicant's Employer & Phone:
This area is reserved for SWGDR use only
Pet Information
Have you ever owned a Great Dane?
Do you currently have any pets?
What kind of pet(s) do you currently own?
How many dog(s) do you own?
Male(s)
Female(s)
Are your pets Spayed/Neutered?
If your pets are NOT Spayed or Neutered, please explain why:
How many hours will the dog be alone per day?
Where will the dog be kept when the family is .........
Home:
Gone for work:
Does anyone in the household have any physical impairments?
When away on vacation, do you.............
If other, please explain:
This space reserved for SWGDR only
Preferences
What gender would you prefer?
What color would you prefer?
What size would you prefer?
Ears:
Age:
Temperment level:
Activity level:
Would you accept a Great Dane mix?
Would you accept a Great Dane with health problems?
* Some rescued danes have pre-existing health conditions or problems that may require further care by the adopter (skin problems, cataracts, etc.)
Are you aware of the yearly costs of maintaining a healthy dog?
*Yearly vaccines can be $70-$100. Then there is heartworm preventative (daily or monthly), flea/tick control (pet and premesis). dental care, food, accessories, as well as many other unforseen items/circumstances (such as accidents or illness).
Are you prepared to meet these requirements?
How soon do you want to adopt this dog?
How much supervision of the dog with your children will be provided?
How would you encourage and reinforce your dog's appropriate or good behavior?
How would you prevent and manage your dog's inappropriate or bad behavior?
Have you ever crated a dog?
Are you willing to crate this dog if needed?
Do you have a crate already?
What size crate:
This space reserved for SWGDR only
Residence Information
Are there other residents in your home besides a spouse and children?
If you checked other, please explain:
Type of residence:
If you checked other, please explain:
Do you ?
If you rent, please provide your Landlord's name and phone number:
Are there any size or weight restrictions on pets where you live?
Location of residence:
How long have you lived at this address?
What is the size of your current living area in sq. ft. :
What is the size of your yard?
Is the yard fenced?
What type of fence:
Height of the fence:
How do you plan to exercise the dog and give it potty breaks?
This space reserved for SWGDR only
Reference Information
*SWGDR will be checking your references
Veterinarian's Name:
Veterinarian's Phone#:
Veterinarian's Address, include city and state:
Name of your closest relative, NOT living with you:
Relative's phone number:
This space reserved for SWGDR only
I ATTEST THAT ALL ANSWERS THAT I HAVE PROVIDED ON THIS APPLICATION ARE CORRECT
I UNDERSTAND THAT SOUTHWEST GREAT DANE RESCUE, INC. HAS THE RIGHT TO REJECT ANY APPLICATION FOR ANY REASON
I AGREE WITH THIS PRIVACY NOTICE:
SWGDR MAY SHARE YOUR APPLICATION INFORMATION WITH OTHER RESCUE ORGANIZATIONS AS PART OF THE APPROVAL AND SCREENING PROCESS
SWGDR will NEVER sell your information or share it with any other outside resources
Type applicant's name to serve as signature:
Type co-applicant's name to serve as a signature:
*Adoption fees:
$300.00 for adult dogs
$500.00 for puppies
*These fees are to offset rescue medical costs. SWGDR is a 501(c)3 organization
