Kaiser Great Danes Puppy Application Form Please answer ALL questions and give ALL preferences in order of your choices. We work from this form to select the most ideal Great Dane puppy for the individual needs of you and your family. A deposit of $300.00 is required to hold your puppy for you family. Complete and return this application to: Name: Street Address: City/Town: Post/Zip: Mailing Address: City/Town: Post/Zip: Phone-day: Cell: Email: Please let us know where you heard about Kaiser Great Danes: Previous address if at current less than 2 years: Current Employer: Active Email: jaidemg@hotmail.com Mail: Tara Ness 3140 Fairview Rd Neenah, WI 54956 Date: State: Country: State: Country: Eves: FAX: Lifestyle Type Number of Ages regularly in the Home (M=male F=female): example 1M 0-4yrs Semi-Active 0-4yrs 10-15yrs 25-45yrs Sedentary 5-10yrs 16-25yrs Over 45 Are there special needs family members in the home? If yes, please explain: If there are young children in the home, have they been exposed to dogs? Was their reaction positive and confident? Has your child ever had a negative experience with a dog? Puppy Application Form 1
If yes, please explain: Who will be the main care giver of the puppy? Is there anyone home during the day? Please check one: Do you own your home? Do you rent? If you rent, please provide an approval letter from your landlord, please be sure they include their phone number. **Please contact your landlord PRIOR to submitting this application.** Other Pets/Animals Currently in the Home/on the Property Have you owned a dog before? If yes, what Breed(s) and at what age and how did they pass: Have you ever had to re-home or relinquish a pet to a animal shelter? If yes, please explain the circumstances: Have you ever had a puppy/dog repossessed from your ownership If yes, please explain the circumstances: Training How much time can you devote to? training 10-15 minutes daily Other, please specify: Who will train your dog? Self Self with trainer/classes Other If other, please specify: Where will the dog be living? Indo or Outdoor Both Have you researched the needs and care of Great Danes? Y or N Are you aware of the dietary needs of a Great Dane? Y or N Where: What dog food do you feed? Puppy Application Form 2
Do you know what bloat is and the emergency treatment is? Y or N Do you have an in-home business, regular scheduled meetings or playgroups that involve, clients, young children (other than your own/family) or a group of strangers (persons not related to you)? If yes, please list any other information you want me to know Why do you want a Great Dane? Personal References (Non Family) Preferably Dog Related Name: Address: Phone: 1 How do you know this person? 2 How do you know this person? List you current veterinarian s information: Intent: Pet ONLY (Limitted AKC) Co-Own Breeding Full AKC Breeding Co-Own Showing Full AKC Showing Keeper Program Puppy Application Form 3
Please Mark Preferred Gender/Colors: Gender: Male Female No Preference Colors: No Preference Black Blue Fawn Dirty Fawn Blue Fawn Lilac Chocolate Brindle Reverse Brindle Blue Brindle Reverse Blue Brindle Patterns: Solid Mismaked Mantle Harlequin Masked Tan Point No Preference ~~PET APPLICATION COMPLETE Please sign last page and submit~~ ~~Co-Owns, Showing, Keeper Program and FULL AKC please continue~~ Puppy Application Form 4
Additional information required for those interested in Keeper Program, CO-Owns, and FULL Registration About your breeding program: Kennel Name: Website: Experience: Keeper Program Total Newbie 1-2 Litters 3-6 Litters Over 6 I need a Mentor I have a Mentor I have Mentored Questionnaire for Breeders: Do you Co-Own or Partner with any other kennels or plan to in the near future? If yes, please list: What are the goals of your breeding program? Have you ever produced deaf/blind puppies? If yes, explain: Have you ever dealt with a complication of pregnancy or whelp? If yes. explain: Have you ever bred a mixed breed litter? If yes, explain: Have you ever had an accidental litter? If yes, explain: Do you breed spot to spot? If yes, explain: Puppy Application Form 5
How do you select new homes for your puppies? What do you do with dogs retired from your program? Have you ever sold a dog or puppy to a pet store, at auction, or to any person or firm connected with the sale or resale of dogs? If yes,explain. Do you sell your puppies on contract? (If yes, please attach a copy of your current contract) Breeds you have shown: Questionnaire for Showing: Accomplishments showing: Please note: We DO T sell puppies to wholesalers, brokers, pet shops or persons purchasing for re-sale. By completing this application you are stating that this puppy is being bought directly as a pet for yourself or family member. Please remember to contact us if any of the above information changes or your circumstances change, such as children now present in the home, change of address, contact details or email, additions to your puppy selection in colors, sizes or sex. Please send all updates to: jaidemg@hotmail.com Please do not send a deposit fee until the application has been accepted. We reserve the right to refuse to sell a puppy at any time during the application/assignment process. Should you use FALSE information on this application, we reserve the right to nullify any contract in place allowing Kaiser Great Danes to then repossess the dog, without notice or refund at any time. If you decide to purchase a puppy from us, do you fully understand that if a deposit is placed to hold a puppy for you, that deposits are Non-Refundable if you decide to back out for any reason. Sign: Date: Puppy Application Form 6