Address Information
Applicant Name
Phone Number (ex. 000-000-0000)
Alt. Phone (ex. 000-000-0000)
Email Address
Street Address (No P.O. Boxes)
City
State	Select State Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming
Zip
Spouse/Significant Other Name
Family Information
Do You Have Children?	Yes No
If So, How Many?	How Many? 1 2 3 4 5 6 7 8 9 10
Approximate Age Ranges	Age Range 0-10 11-15 16-20
Do You Have Any Other Pets?	Yes No
If So, How Many?	How Many? 1 2 3 4 5 6 7 8 9 10
Please List The Types Of Pet, And Their Approximate Ages.
Who Will Be The Primary Caregiver For The Puppy?	Caregiver Myself(Applicant) Spouse/Sig. Other Other
If Other, Please Specify
Will The Primary Caregiver Stay At Home?	Yes No
What Provisions Will Be Made For The Puppy While The Primary Caregiver Is Away?
General Information
Where Will The Puppy Sleep?
Where Will The Puppy Spend Its Days?
Do You Have A Fenced In Yard?	Yes No
If Not, How Do You Plan To Contain The Puppy While It Is Outdoors?
Do You Have A Veterinarian?	Yes No
If So, What Is The Phone Number?
Breed Specific Information
Have You Ever Owned A Great Dane Or Giant Breed Of Dog Before?	Yes No
What, If Any, Research Have You Done On The Breed?
What Type Of Diet Plan Do You Plan To Feed The Puppy?	Raw Commercial Dog Food
What Kind Of Puppy Are You Looking For? (Check All That Apply)	Select Type Male Female SelectType Pet Quality Show Quality Select Type Companion Guard Dog
Personal References You Must Have At Least Two Personal References.
Name City State Ph. Number     Select State Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming         Select State Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming     Select State Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming
Please list any other questions, concerns, or comments here.