Adoption Application

 Yes    No

Yes   No

Name:

Address:

City:

State:

Zip

Phone Number:

Email:

Reason for adoption?

Is anyone in home allergic to dogs?

Do you own your home?

Do you rent?

If renting, will your landlord allow dogs over 50 lbs?

Do you have a fenced yard?

If yes, what is the type and height of fence?

Where will dog be kept during the day?

Where will the dog be kept at night?

Is anyone home during the day?

How long will dog be left alone during the day?

Do you have other animals and if so, do they get along with other pets?

Golden's shed all  year, will you groom him yourself or use a groomer?

Golden's are active and need exercise.  Will the dog be walked daily,

exercised in fenced yard or be allowed to run free?  Explain:

Do you plan to attend obedience class?

Please provide name & addrress of most recent Veterinarian:

Can we contact your Veterinarian?

What age Golden are you interested in adopting?

Do you prefer?

Would you consider a special needs dog, such as one who requires medicine for a permanent but controlled condition?

Please tell us about yourself and family, including activities that your dog would be included:

IF YOU ARE NO LONGER ABLE TO CARE FOR THE DOG ADOPTED FROM US, WE REQUIRE YOU CONTACT US AND WILL WILL TAKE

HIM/HER BACK OR APPROVE A HOME YOU HAVE FOUND.  IS THIS AGREEABLE?

Applicant's Signature:

Co-Applicant's Signature:

Male    Female        Doesn’t  Matter

Yes      No   Depends on condition

Yes   No

Yes

No

Type name

Type name

Yes  

No

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