Adoption Questionnaire

BuckLand Kennel (BLK)

Please tell me a little bit about yourself.
All information shall be kept confidential and shall only be used to help determine if one of my puppies may be suitable for your family.

Personal Information
Bold Fields are Required

First Name:
Last Name:
Address Line 1:
Address Line 2:
City:
State/Prov:
Zip/Postal Code:
Phone Number:
E-Mail:

Supplemental Information
Please fill in as much information as possible.

When is the best time to reach you:
Marital Status:	MarriedSingleDivorced
Do You have Children:	YesNo
If "YES" what are their ages:
Do you currently have any other pets:	YesNo
If "YES" what types, ages, and temperament::
Are They Spayed or Neutered:	YesNoNot All
If "Not All" which ones are not:
Please tell me about the environment you will provide for the puppy/dog:
Do you:	OwnRent
If you "Rent" have you OK'd it with your Landlord:	YesNo
Which type of environment best describes where you live:	UrbanSuburbanRural
Do you have a fenced yard:	YesNo
If "YES" what type of fencing:
Usually, how many consecutive hours will the puppy/dog be left alone during the day:
Have you owned a great Dane before:	YesNo
What qualities do like about the Great Dane breed:
Why are you interested in purchasing a Great Dane:	CompanionShowingBreeding ObediencePet TherapyOther
If above selection is "Other" please explain:
If above selection is "Showing" would you be in favor of Co-Owning the dog until they are a finished Champion	YesNo
If "Co-Own No" selected Please Explain
Are you interested in Male or Female:	MaleFemale
What color are you looking for:	HarlequinMantle(Boston) Black and WhiteMerle

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Email Us

Send mail to Rich@eBuckland.com with problems or comments about this web site. Copyright © 2007 BuckLand Kennel Last modified: 12/02/09

Send mail to Rich@eBuckland.com with problems or comments about this web site.
Copyright © 2007 BuckLand Kennel
Last modified: 12/02/09