Waters Edge Animal Rescue Adoption Application

Application Date:

Date

Applicant Name(s):

Applicant Address (Address/City/State/Zip):

Applicant Phone Number: (Home/Cell/Work)

Applicant Email:

How did you hear about WEGDR?

Do you rent or own your own home?

Own Rent Live w/relatives

If renting: Landlord"s Name/Phone #

List the ages of everyone in your home.

What kind of food do you do you feed your dog?

What do you use for heartworm prevention?

Do you have a fenced in yard? If yes, what type and how high?

Why do you want a dog?

Have you ever had a Great Dane before? If so, please explain.

Are you aware of bloat in the Great Dane breed? if so, please expalin.

Will someone be home during the day?

Yes No

Have you ever had a dog before?

Yes No

If yes, what happened to the dog(s) that you have had in the last 5 years (mark all that apply)?

Still have Gave away Ran Away Died - see below Other

Reason for death:

How many animals do you currently have? List type(s)/Breed(s)/Age(s)

Are all of your current pets up to date on their vaccines? Spayed or neutered?

Where will the dog be kept during the day?

Where will the dog be kept at night?

Where will you take your dog for veterinary care? Vet Name/Phone#:

Have you ever been convicted of or received citations for the abuse/neglect of an animal?

Yes No

If yes, please provide information below:

List three references with addresses, phone numbers, and your relationship to them (only 1 family member can be used).

1)

2)

3)

To ensure the continued welfare of all animals adopted from Waters Edge Great Dane Rescue requires that in the event an individual or individuals are unable to continue to care for the animal, it be surrendered back to the rescue.

Do you agree to abide by the above directive?

Yes No

I, the undersigned applicant, understand that the Waters Edge Animal Rescue maintains the right to contact references and to deny this application. I understand that adoptions are NOT first come, first serve, and that the best available home will be chosen for the animal. I hereby certify that all information given is truthful and accurate.

Applicant Signature:

Co-Applicant Signature:

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Waters Edge Great Dane Rescue, Inc. Application