Adoption/Foster Application Copy

I want to ____ a Golden Retriever. * Adopt Foster
Enter the PayPal transaction confirmation number in the field below. If you are applying to foster a Golden, just enter the word "foster". *
SECTION 1. PLEASE TELL US ABOUT YOU
Name * Title First Last Suffix
Email *
What is the best time to contact you? *
Date of Birth * / MM / DD YYYY
Home Phone * - (###) - ### ####
Work phone - (###) - ### ####
Cell phone - (###) - ### ####
Address *
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Occupation *
Describe your work or daily schedule *

For example: home after 5pm, traveling during weekdays, night shift, etc.
Is another member of your household co-applying with you for a Golden? * I do not have a co-applicant (check box and skip to section 2) I do have a co-applicant (provide his/her data below)
Co-Applicant's name Title First Last Suffix
Co-Applicant's date of birth / MM / DD YYYY
Co-Applicant's Occupation
Describe Co-Applicant's work or daily schedule

For example: home after 5pm, traveling during weekdays, night shift, etc.
Co-Applicant's phone - (###) - ### ####
SECTION 2: ENVIRONMENT FOR THE GOLDEN
When will you be ready to adopt/foster a dog? *
List other people who would live with dog and their ages *
Do small children regularly come to visit your home? * Yes No
Is anyone home during the day? * Yes No
Do you have cats? * Yes No
If you own other pets, list their species, genders, and ages *

If you do not own other pets, enter "no pets"
If there are other dogs in the home, are they spayed or neutered? * Yes No I don't have other dogs at home
Does anyone in your household have dog allergies? * Yes No Don't know
Have you owned a Golden Retriever before? * Yes No
Are you aware of the shedding? * Yes No
What is the gender AND age that your ideal Golden would be? (check all that apply) * Male Female Ages 1-3 Ages 3-6 Ages 6-9 Ages 9+ No preference, I will love any dog!
Will you consider a special needs dog, such as one who requires medication for a permanent but controlled condition? * Yes No Maybe
Have you bred dogs in the past? * Yes No
Do you plan to breed dogs in the future? * Yes No
Will the dog be allowed on the furniture? * Yes No
Will the dog be allowed to run free? * Yes No
If so, when and where? If not, why? *
Where will the dog be kept during the day? *
Where will the dog be kept at night? *
What will you do with the dog when you go on vacation? *
What are your thoughts on crating? *
How will the dog be exercised? *
How will the dog be walked? *
How often and for how long will you be able to walk your dog? *
Describe the freedoms you will allow your dog *
Who is the Golden primarily for? * Child/Children Adult(s) Both
Describe the type of dog you feel would best fit into your household and any lifestyle requirements you may have: *
SECTION 3: HOME & OUTDOORS
Type of home * Single/Family Condominium Apartment Townhouse Other
Home ownership status * Own Rent
Potential access to water (swimming) * My home is by a lake My home is by a canal My home does not face water at all My home has a fully fenced pool My home has an unfenced pool My home has a fenced/covered spa My home has an unfenced/open spa I WILL allow my Golden to swim I WILL NOT allow my Golden to swim
It's very important to know that the great majority of Golden retrievers LOVE to swim!
Fencing/containment * I have a fully fenced back yard I have a partially fenced back yard My back yard is not fenced
It's very important to know that the great majority of Golden retrievers LOVE to swim!
How will you train your Golden regarding water? *
Do you use a doggie door, doghouse, kennel, tie-out? (check all that apply) * Doggie door Dog house Kennel/Dog run Cable runner or tie-out I have none of the above
If so, please describe how you use or plan to use it/them. If not, enter "N/A". *
What is your understanding of maintenance costs, including monthly Heartworm, Flea, and Tick preventative medications? If you're not sure or have questions, please use this space to ask. *
Do you plan to take obedience classes with your dog? * Yes No
Why did you choose a Golden Retriever? *
Why adopt from a rescue? *
Have you adopted from a rescue before? * Yes No
Have you ever placed a dog in a shelter, or given a dog away? (if "yes", please explain) *

If this doesn't apply, enter "N/A".
List circumstances under which a previous dog was lost or died, if applicable; otherwise, enter "N/A". *
Current or future veterinarian who will care for your golden retriever (provide name, address, and phone number) *
Provide the name, address and phone number of a local personal reference we can call if needed *
Please tell us about your family and include any additional information that will help us process your application *
By checking the box below, I certify that both I, The Applicant and, if indicated, my Co-applicant, have answered the above questions truthfully; and that I/we agree to have a volunteer from Everglades Golden Retriever Rescue, Inc. conduct a home visit to verify these answers for the safety of the dog and those living in my home. * I agree with and accept these terms

Adoption/Foster Application Copy

Adoption/Foster Application Copy

SECTION 1. PLEASE TELL US ABOUT YOU

SECTION 2: ENVIRONMENT FOR THE GOLDEN

SECTION 3: HOME & OUTDOORS