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Name of Applicant: |
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Email Address: |
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Your age: |
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I am interested in: |
Adopting a Golden Retriever
Fostering for GRRMF
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I will/have submit(ted) my application fee by: |
Paypal
Mailing a check
This is a foster application; no fee is necessary
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Where did you hear about us? |
Internet
Petsmart or other event
Friend
TV
Other
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If you answered "other" above, please describe. |
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Street Address: |
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City: |
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State: |
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Zip Code: |
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Day Phone Number: |
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Evening Phone Number: |
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| Cell Phone Number: |
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Occupation: |
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Work Schedule: |
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Best time to contact you (check all that apply): |
Morning
Afternoon
Evening
Weekends
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Name of Co-Applicant: |
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Occupation: |
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Work Schedule: |
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Relationship to Applicant: |
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Is anyone home during the day? |
Yes
No
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If so, who is home during the day? |
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Other people who will be living with the dog (Please list ages of children - if no one else will live with the dog please enter NA): |
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Do you have children that typically come to visit your home? If so, please describe: |
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On a typical day, how many hours are you away from home (including commuting time)? |
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Is the pet for a(n) (check all that apply): |
Adult
Child
Elderly person
Physically challenged
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Do you live in a: |
House
Townhouse
Apartment
Duplex
Condo
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Do you own or rent: |
Own
Rent (If you rent, have you checked with your landlord for approval and have you paid any applicable pet deposits? Please include a letter from you landlord giving you authorization to have a large (60-85 lb) dog live in your home.)We cannot process your application until we receive this. |
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Do you have a fenced-in yard? |
Yes
No
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Is it fenced on all sides, so that the yard is fully enclosed? |
Yes
No
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How high is the fence? |
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What type of fence do you have?(Check all that apply) |
Chain link
Wood Stockade
Wire and Post Field style
Electric/Invisible
Other type of fence
No fence
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If you selected Other type of fence, please describe: |
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Is the fence capable of restraining a 60 - 85 lb large dog? |
Yes
No
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Does the fence have any gaps or holes? |
Yes
No
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If you don't have a fence are you willing to install one? |
Yes
No
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Do you have a dog kennel or dog house in your backyard? |
Yes
No
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If yes, when will your dog use it? |
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Will you use a chain, tie out or cable runner to restrain your dog outside? |
Yes
No
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If you answered Yes above, please describe how and when you would use it: |
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Do you live on a lake, canal, or retention pond? |
Yes
No
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If you answered Yes above, please describe: |
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Do you have a pool? |
Yes
No
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If you have a pool, does it have a screened enclosure or safety fence? |
Yes
No
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If you have a pool, is your dog allowed in it? |
Yes
No
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How will the pet access the backyard from your home? |
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Regarding your dog's everyday living situation, would he/she (check all that apply): |
have full run of the home
be blocked from certain parts of the home
live in a crate/pen
live on the porch or outside
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Please explain: |
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Will your dog be allowed on (check all that apply): |
furniture
bed
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Additional comments about allowing dog on furniture/bed: |
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Where will the pet be kept during the day? |
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Where will the pet be kept at night? |
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Where will the pet be kept when you are away from home on a typical day? |
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Where will the pet be kept when you travel and are away from home for extended periods of time? |
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Do you have a doggie door? |
Yes
No
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If you have a doggie door, please describe its location: |
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When will your dog have access to the doggie door? |
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How will you exercise your dog? |
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Will the dog be walked? |
Yes
No
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How often will the dog be walked? |
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Will the dog be walked: |
On leash
Off leash
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Will the dog be allowed to run free off leash? |
Yes
No
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If the dog will be allowed to run free off leash, please check under which situation the dog would be allowed off leash -- Please check all that apply: |
While playing in the front yard
In the backyard
In the neighborhood
During walks
While swimming
At the beach
At the golf course
In local fields
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If the dog will be allowed to run free off leash any other time, please describe: |
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Who will be primarily responsible for the care of the dog? |
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Will this be your first dog? |
Yes
No
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If not, what breed(s) have your previously owned? |
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Have you ever had a Golden Retriever before? |
Yes
No
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List any other pets you currently have including the type of animal (please list the breed for dogs) their age(s) and whether or not they are spayed or neutered: |
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If you currently own or have owned a golden retriever, please indicate whether male or female and how much they weigh(ed): |
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What brand of food do you/did you feed your dog? |
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How many times a day do you/did you feed your dog? |
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How often do you/did you brush your dog? |
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Golden retrievers are known to shed. Does dog hair bother you? |
Yes
No
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Regarding grooming, will you: |
groom the dog myself
take my dog to a professional groomer
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Do you plan on shaving the golden or (if applicable) have you shaved your previous goldens? |
Yes
No
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Is/was your dog on heartworm preventative? |
Yes
No
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If yes, how many months of the year? |
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Have you investigated the costs of owning a dog, and are you able to financially provide for the dog's needs? |
Yes
No
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Do you plan on taking an obedience course with your new golden? |
Yes
No
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If no, why not? |
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Have you ever bred a dog? |
Yes
No
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Do you plan to breed dogs? |
Yes
No
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How many hours between 1 and 4 (or more) are you willing to drive to view a dog? |
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Have you ever sold, given away or put a dog in a shelter? |
Yes
No
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If you answered yes above, please tell us why: |
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If your previous pet(s) have died due to illness or accident, please explain: |
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Please give the name, address and phone number of your current veterinarian along with current or previous pet's names (GRRMF reserves the right to contact any parties listed on this application.): |
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Please give the name, address and phone number of your nearest relative or significant other (GRRMF reserves the right to contact any parties listed on this application.): |
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Please choose the age range(s) for the dog that you would consider(Check all that apply): |
1 - 3 years
3 - 6 years
6 - 9 years
over 9 years
Any age
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Do you prefer: |
Male
Female
Doesn't matter
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If you have any special requirements or preferences (so we can more carefully match a dog to your lifestyle) please describe: |
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Would you consider a special needs dog such as one who requires medication for a permanent but controlled condition? |
Yes
No
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If you haven't had a dog in the past, why are you considering getting one now? |
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Have you sent in an application for adoption to any other rescue groups besides GRRMF? If so, which ones and when did you apply? |
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Please provide a detailed essay (400 words or so) about why you want to adopt a golden retriever from GRRMF. Give us as many details about your family and lifestyle, and an idea of a "typical day in the life" of your new golden retriever. This is a very important part of your application--we need this information so that we can match a dog to your family and lifestyle. Applications with only a few sentences will be returned for more information. |
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If you prefer, enter NA here and create a separate document (such as Microsoft Word) and upload it below. |
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If you would like to upload a file with your essay about why you want to adopt a golden retriever, please do so here. |
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By clicking Yes, I acknowledge that I understand that submitting this application does not guarantee the adoption of a Golden Retriever from GRRMF, nor does it guarantee the adoption of any specific dog. GRRMF reserves the right to reject any applicant.
Yes |
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By clicking Yes, I acknowledge that all information contained in this form is true and correct to the best of my knowledge. I understand that any misrepresentation of fact may result in the removal of the adopted dog from my home by GRRMF. Applicants must agree to a home visit.
Yes |
By clicking Yes, I also acknowledge that a $10 non-refundable application fee is required and that I will remit the fee via Paypal or I will send a check to GRRMF, PO Box 1449 Goldenrod, FL 32733-1449 as soon as possible.
Yes
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For Renters--I understand that before being considered as a potential adopter, a letter from my landlord is required approving a large (70 pounds +) dog as an occupant at the rental property. Send via fax to 419-781-3538 or US Mail to GRRMF, PO Box 1449, Goldenrod, FL 32733
Yes
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