Adoption Application
Name:
Address:
City: State: Zip Code:
Phone Number: Email:
Why do you want to adopt a Golden Retriever?
Is there anyone in the home that may be allergic to dogs? Yes No
Do you own your own home? Yes No
Do you rent? Yes No
If renting will your landlord allow a dog over 50 pound? Yes No
Do you have a fenced yard? Yes No
If yes, What type and height of fence?
Where will the dog be kept during the day?
Where will the dog be kept at night?
Is anyone home during the day? Yes No
How long will the dog be left alone during the day?
Do you have other animals and if so do they get along with other pets? Yes No
Goldens shed all year, will you groom him yourself or use a groomer?
Goldens are active and need exercise. Will the dog be walked daily? Exercised in a fenced yard? Be allowed to run free? Explain:
Do you plan to take an obedience course? Yes No Have knowledge of training and will train myself Depends on the dog
Please provide the name, address and phone number of your most recent veterinarian:
May we contact your Veterinarian? Yes No
Rescued Goldens range in age: Are you interested in adopting:
Puppy (9 wks-2 years old) Adult (2+ years old) Senior (9+) Does not matter
Do you prefer: Male Female Does not matter
Would you consider a special needs dog, such as one who requires medicine for a permanent but controlled condition? Yes No Depends on the condition
Please tell us about yourself and your family, including special 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 WE WILL TAKE HIM/HER BACK OR APPROVE A HOME YOU HAVE FOUND. IS THIS AGREEABLE? Yes No
Applicant's Signature
Co-Applicant's Signature
Adoption Fees:
$150.00-18 months or under
$125.00- 18 months-4 years
$100-4 -7 years old
$25- Senior