Adoption Application

What age Golden are you interested in adoptiong? *

Puppy

Adult (2+ years)

Senior (9+ years)

Doesn't Matter

Please tell us about yourself and family, including activities which would include your dog: *

City, State and Zip: *

Do you have any other animals and if so, do they get along? *

Yes

No

Applicant's Signature (Type Name): *

Do you have a fenced yard? *

Yes

No

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

Self

Groomer

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

Email: *

Is anyone in home allergic to dogs? *

Yes

No

Do you Own your home or Rent? *

Own

Rent

Address: *

If you rent, does your landlord allow dogs over 50lbs? *

Yes

No

N/A

Where will dog be kept during the day? *

Phone: *

Is anyone home during the day? *

Yes

No

Please enter Name and Address of your most recent Veterinarian: *

Where will dog sleep at night? *

Can we contact your Veterinarian? *

Yes

No

If you do have a fenced yard, how tall is it? *

How would your dog get exercise? Would you walk him, let him play in fenced yard or let him run free? Please explain: *

Name: *

Co-Applicant's Signature (Type Name):

Would you consider a dog who requires medication for a permanent but controlled condition? *

Yes

No

Depends upon the condition

Reason for Adoption: *

How long will dog be left alone during the day? *

Do you plan to attend obedience training? *

Yes

No

Don't Know

Do you prefer: *

Male

Female

Either