Great Dane Rescue : About Us : Surrender Your Dane : Application

Select your location within our coverage area *REQUIRED*

Owner Name *REQUIRED*

Street Address *REQUIRED*

City, State & Zip *REQUIRED*

Email *REQUIRED*

Work Phone *REQUIRED*

(Include Area Code)

Home Phone *REQUIRED*

Registered Name *REQUIRED*

AKC Number *REQUIRED*

Call Name *REQUIRED*

Sex

Male
Female

Age *REQUIRED*

Color *REQUIRED*

Breeder Name *REQUIRED*

Organization *REQUIRED*

Street Address *REQUIRED*

City, State & Zip *REQUIRED*

Email *REQUIRED*

Work Phone *REQUIRED*

(Include Area Code)

Home Phone *REQUIRED*

Website URL *REQUIRED*

Name *REQUIRED*

Street Address *REQUIRED*

City, State & Zip *REQUIRED*

Email *REQUIRED*

Work Phone *REQUIRED*

(Include Area Code)

Date of current shots *REQUIRED*

(mm/dd/yy)

Has the dog been tested for heartworms

Yes
No
Unknown

Is the dog on HW preventative

Yes
No
Unknown

Is the dog spyed or neutered *REQUIRED*

Yes
No
Unknown

Has the dog been bred

Yes
No
Unknown

Is the dog housebroken

Yes
No
Unknown

Has the dog been obedience trained

Yes
No
Unknown

Is the dog good with children

Yes
No
Unknown

Is the dog good with other dogs

Is the dog good with small animals such as cats

Yes
No
Unknown

Is the dog crate-trained?

Yes
No
Unknown

List any known habits the dog has *REQUIRED*

Does the dog have any preferences to

Men
Women
Unknown

If the dog has ever bitten a person or another animal, please give details below *REQUIRED*

Does the dog have any known allergies or medical conditions *REQUIRED*

Reason this dog is dog is being surrendered *REQUIRED*

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About Us

Application

GDR Inc's coverage area includes Michigan, Ontario, parts of Wisconsin, Illinois, Indiana, parts of Ohio, parts of Kentucky, Alabama and parts of Georgia and Arizona. Please click the link above if you are not in our coverage area.

Contact information of person submitting request:

Description of Great Dane, hereinafter referred to as "dog"

Please provide the breeder information

Please provide the vet's information

Additional information: