Puppy Application Form (All fields are required) First Name: Last Name: Email: Phone Number: Address: Names & Ages of all household members: City, State, and Zip: How long at this address? Rent or Own? OwnRent Type Of Home: SingleDuplexTownhouseCondoApartmentModular / Mobile Home Is the property fenced? YesNoPartially Employer (with address & contact info): Spouse's Employer (with address & contact info): How long at current employer? Who will be the primary caretaker of the puppy? How long will the puppy be alone during a regular work day? Describe where the puppy's primary place in your home will be. Where would his/her bed be when with family? Have you had experience with crate training? YesNo Have you ever completed an obedience training course? YesNo Do you currently own any other pets? YesNo If yes, please list breed, type, and ages: Please describe your current pets (i.e. dominant, submissive, active, couch potato, kid friendly...etc): Have you ever owned a Great Dane? YesNo If yes, please describe when, colour, sex, and what happened to the dog: Have you ever been charged with neglect, abandonment, or anything else with concern to harming a dog? YesNo Please list by number of importance 1-5 (1 being least) the reasons you would like a great dane (slider left is 1 & slider right is 5): Agility (1-5) Breeding (1-5) Family Companion (1-5) Obedience (1-5) Service / Therapy Dog (1-5) Show Dog (1-5) Other (1-5) Have you ever shown a dog (or paid a handler) to it's championship? YesNo Who will be responsible for taking the required Star Puppy / Puppy Kindergarten classes with your new puppy? Do you understand that Great Dane puppies (3-24 mos) are not able to do a lot of jumping or road work as it may cause developmental problems? YesNo Do you understand that dane puppies are to eat a quality food that provides "a medium range" 21-24% protein and about 12% fat, 3 times per day until 6 months of age, 2 times daily until 18-24 mos, to ensure keeping the puppy lean, not fat or heavy? YesNo Do you have the basic understanding that there are NO BREEDS of dog that are totally free of health issues, and that we breed dogs that have been health tested as a tool to get to healthier companions? YesNo Are you aware that cropped ears may take many months of wrapping in tape by you to make them stand? YesNo Please provide the Name, Address, and Phone Number of your veterinarian: Please list three references (name, address, phone number, how you know them, and for how long): Reference 1: Reference 2: Reference 3: Would you be open to a home visit from myself or another breeder acting as my agent? YesNo Are you interested in a male or female puppy? MaleFemaleNo Preference Would the puppy's ears be cropped or left natural? CroppedNatural Since we try to hold puppies for serious inquiries only, do you understand that once you hold a spot with the $500 USD deposit this money is NON REFUNDABLE? YesNo Thank you for your interest in a Regal Black Great Dane puppy. We look forward to receiving your application.