Waiting List Form

*Full Contact Information : Full name, Home address, City, State, Zip code, Home phone number & Cell phone number :
*Email address (s) : Website including - Myspace, Face book etc. :
Please tell us which breeding you are interested in : *Please tell us what ( sex - male or female ), ( color - brindle or fawn ) and quality ( show - breeding or pet ) you are interested in :
Have you ever owned this breed before ? If no, please explain why you would like to own this breed :
Do you have a fenced in yard ? If no, please explain how you will keep this puppy contained for its safety :
*Are you willing to take puppy to training classes?
Yes
No
*Do you own any dogs now ?
Yes
No
If yes, please explain what breed, sex and age they are :
*Have you ever been turned in, investigated or had any of your animals removed from your home for animal cruelty or neglect?
*Veterinarian's Name, Complete Address, Phone number (including area code) as well as fax number and email if available:
How many years have you been with this Veterinarian?
*May we have permission to speak with your Veterinarian ?
Additional info or questions for Lookout Danes :

LOOKOUT DANES

Home Of The "Gentle Giants" Breeding Quality Fawns & Brindles

Waiting List Form