Name of Applicant
*
First Name
Last Name
Name of Co-Applicant
First Name
Last Name
Relationship to Applicant
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Applicant Phone
*
(###)
###
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Co-Applicant Phone
(###)
###
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Applicant's Email
*
Co-Applicant's Email
Employer (Applicant & Co-Applicant)
*
Have you PREVIOUSLY adopted from NRGRR?
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If so, list dog’s name at time of adoption and year.
How did you hear about NRGRR?
*
Please list all members of your household, including yourself.
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Include ages for children.
If you do not have small children living in your home, will your dog come into daily/weekly/monthly contact with children?
Such as grandchildren, neighbors, etc.
If yes, please describe:
Are you aware that Golden Retrievers are large dogs and can unintentionally knock down children, the elderly, or adults?
*
Does anyone in your household have allergies to animals?
*
If yes, please describe:
Are you aware that Golden Retrievers shed year-round?
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Are you aware that golden retrievers are very active dogs and need plenty of exercise?
*
Who will be the primary caretaker of your dog?
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Will this be your first dog as an individual/family?
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Not including previous family pets as a child.
Please list all other CURRENT dogs in your household.
*
Include dog's name, breed, sex, age, and if they are spayed or neutered.
Please list all other CURRENT pets (other than dogs) in your household.
*
i.e. cats, hamsters, birds, etc.
Include pet's name, type, sex, age, and if they are spayed or neutered.
If you currently do not have a dog, have you ever owned one before?
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Please list all dogs that have passed away and the approximate date.
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Have you ever sold, given away or surrendered a pet?
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If Yes, please explain in detail.
Have you ever owned a Golden Retriever?
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Do you own or rent your home?
*
If you rent your home, do you have permission to have a dog over 50lbs?
Landlord's Phone
(###)
###
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Do you have a fenced yard?
*
If yes, please list fence type and height and the approximate square footage of the fenced yard.
Example: Wooden, 6 foot, 1000 sq ft yard.
Do you have stairs in your home?
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How many steps?
Example: Stairs outside = 3 steps
Stairs inside = 10 steps
How long on average will the dog be alone (without humans) during the day?
*
Where will your dog be while you are away from the house?
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i.e. crated, baby gated, outside, free roam in the house.
When you crate your dog how long will the dog be crated; under what circumstances and where?
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Will your dog EVER be kept in an unfinished basement or garage?
*
If yes, please describe.
Will your dog ever be kept outside in a yard or outdoor kennel for extended periods of time?
*
If yes, how long? Please describe.
Where will your dog be while you are asleep/where will it sleep at night?
*
List name, phone number, and full address of ALL VETERINARIANS who have treated your animals:
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Inlcude: animal name, dates treated, vet name or practice, phone number, address
Are you aware that routine costs of maintaining a dog, including vet care, food, heartworm preventative and flea/tick control average $1200-$1500 per year?
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Year-round heartworm prevention is critical. Are you willing to provide this for your dog?
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What kind of heartworm prevention do you use or plan to use?
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How often do you administer the heartworm prevention?
*
What type and brand of flea preventative do you use or plan to use?
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How often will you administer the flea and tick preventative?
*
How will the dog be exercised?
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i.e. running (how far/often?), walks (how far/often?), playing in the yard, etc.
If you work an eight-hour day out of the home let us know if you would consider making arrangements for your dog to have a mid-day break, or if you would consider doggie day care.
*
If you are seeking to foster/adopt a puppy and you are not at home during the day, what arrangements will be made to provide for the puppy’s need to relieve itself and eat during the day for the first few months.
Are you interested in a certain NRGRR dog?
Note: Our dogs are placed quickly so there is no guarantee that the dog you will be interested in will still be available when your application is approved.
Age Range:
*
Please check one or more.
Sex:
*
Activity Level:
*
Please check one or more.
How would you categorize your experience with dogs?
*
Would you consider a dog with special needs?
*
If yes, what type of needs would you consider?
If yes, please explain why you are interested in a special needs dog.
i.e. experiences, training, etc.
Please include any additional information you would like us to know. We encourage you to tell us about yourself and your family, including any special activities in which your NRGRR dog would be included.
*
Your lifestyle, interests, and previous experiences are all helpful to know. This information will assist our applicant advisers in matching our dogs with adopters.
Please list any other rescue groups applied to:
*
Friend or Neighbor #1
*
First Name
Last Name
Phone
(###)
###
####
Friend or Neighbor #2
*
First Name
Last Name
Phone
(###)
###
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