Adoption/Foster Application Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.I am interested in: *Providing a temporary FOSTER HOMEADOPTING a Golden by providing a FOREVER HOMECONTACT INFORMATIONName *FirstLastEmail *Address *Address Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeHome Phone *Cell Phone *Who will be the dog's primary caregiver? *How did you hear about Love a Golden Rescue? *MOTIVATIONWhy do you want to adopt or foster a rescue dog? *HOME OCCUPANTSIs there anyone in the home who may be adversely affected by the care of dogs (allergies, etc.)? *yesnoPlease describe the situation. *Names and ages of people who will be living with the dog: *If children are in the home, what has been their past experience with dogs? *Do ALL members of the household want this dog? *yesnoIf someone is unsure about getting a dog, why? *Are you aware that a Golden Retriever is a large dog and may jump up and knock down children or the elderly? *yesnoHOME INFORMATIONPlease describe your dwelling: *Single Family HomeHome with acreageDuplexTownhouseCondominiumApartmentYour dwelling, do you: *OwnRentIf you rent, do you have the landlord's permission to have a dog over 50 lbs? *yesnonot applicableDo you live on a busy street? *yesnoDo you plan to move withing the next year? *yesnoIf planning to move, please explain: *Do you have a PHSICALLY fenced yard? *yesnoIf you DO NOT have a physically fenced yard, you DO NOT meet the criteria to adopt from Love a Golden Rescue. An “invisible fence” is not considered a physical fence. You will NOT be able to SUBMIT this aplication WITHOUT a physical fence. Type of Fence: *Height of Fence: *Is the fenced area secure for a dog and safe from other dogs outside the fence? *yesnoHow do you plan to use this area? *DOG EXPERIENCEWill this be your first dog? *yesno dog? dog? you Will this be your first Golden? *yesnoDo you have one or more dogs now? *yesnoHow many dogs? *Is/are your dog(s) spayed or neutered? *yesnosome are some aren’tPlease explain: *Why not? *In order to adopt from Love a Golden Rescue all pets already in the home must be altered (spayed or neutered) unless there is a valid medical reason which can be confirmed with a veterinarian. Are all the dogs you own currently own on flea & tick prevention? *yesnoWhy not? *What brand of flea & tick prevention do you use? *Where do you purchase your dog's flea & tick prevention? *Are all your dogs currently on heartworm preventative? *yesnoWhy not? *What brand of heartwork preventative do you use? *Where do you purchase your heartworm preventative? *List the names, ages, breed and gender of your current dogs and whether they are spayed or neutered: *What other breeds have your owned in the past? *OTHER PETSDo you have cats in your home *yesnoPlease list the number of cats: *Are your cats spayed or neutered? *yesnoSome are and some aren’tWhy not? *Please explain: *How do your cats relate to dogs? *How would you introduce them to a new dog? *Where do you feed your cats? *Where is the litter box? *List any other pet(s) you have: *What age and how did you acquire your current pets? *Do you plan to get any additional dogs or cats within the next year? *yesnomaybeHave any of your pets ever been diagnosed with heartworms? *yesnosome have and some have notHow was the heartworm condition resolved? *Please explain: *Have you ever bred a dog? *yesnoHave you ever sold a pet? *yesnoHave you ever given away a pet? *yesnoHave you ever surrendered a pet to a shelter *yesnoIf so, please describe the circumstance: *YOUR PLANS FOR A NEW ADOPTED OR FOSTER DOG:How would you exercise the dog? *How often do you plan to walk the dog? *Where will the dog be kept during the day? *Where will the dog be kept during the night? *Is there someone at home during the day? *yesnoWho? *How long will the dog normally be left alone each day? *Will your dog have the run of the house, be in blocked-off portions of the house, use a crate, be tied outside or live in the yard? Please be specific: *Are you aware that routine costs of maintaining a dog average $800 – $1,000 per year? *yesnoCan you handle this expense? *yesnoWill your dog be allowed on the furniture or bed? *Are you aware that Goldens are active and that they shed all year long? *yesnoWill you groom the dog yourself? *self groom onlyprofessional groomer onlycombination of self and professional groomingWill the dog be allowed to run free? *yesnoIn what activities would your dog participate (e.g. jogging, camping, agility classes, therapy dog, etc.)? *Do you plan to take an obedience course with your dog? *yesnoHave you ever taken an obedience class? *yesnoWhere would you take an obedience class? *REFERENCES AND CONTACTSI hereby authorize my veterinarian to release confidential information about my pets and my pet care: *yesIf you are a current or recent pet owner, during the application process we eill contact your veterinarian directly. Some vets require you to authorize this. Veterinarian's Name *Vet's Address: *Vet's Phone Number: *If you adopt a dog from Love a Golden Rescue, will you provide Love a Golden with periodic updates about the dog? *yesPLEASE NOTE: If you adopt a dog from Love a Golden Rescue, you will be required to release the dog back to Love a Golden Rescue if you no longer wish to care of the dog. In the spaces provided below, please provide two (2) personal references that we may contact. Reference 1 Name: *Reference 1 Relationship to Applicant: *Reference 1 Phone: *Reference 1 Address: *Address Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateReference 2 Name: *Reference 2 Relationship to Applicant: *Reference 2 Phone: *Reference 2 Address: *Address Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateAdoption of Fostering PreferencesAge of dog you are interested in adopting or fostering (check all that apply): PLEASE NOTE THAT WE RARELY HAVE PUPPIES *any agepuppy (1 yr or less)young adult (1-3 yrs)adult (4-8 yrs)senior (9+ yrs)PLEASE NOTE THAT WE RARELY HAVE PUPPIES Do you prefer: *malefemaleeitherActivity level (check all that apply): *Low energy (couch potato)medium energy (some exercise but not intense)High energy (lots of daily exercise)How far would you be willing to travel to pick up a dog for adoption or to foster? *Would you consider a special needs dog, such as one who requires medication for a permanent, but controlled, condition? *yesnoDescribe the personality characteristics which you would like your dog to have: *If you adopted a dog that chews, digs or has other bad habits, what would you do? *If your dog developed a serious health problem, what do you think your limitations would be? *Please tell us about yourself and your family, include any special activities in which your dog would be included: *Are you interested in any particular Love a Golden dog? *yesnoSpecific dog's name: *Rescue groups often work together. Have you applied for a dog with another rescue group? *yesnoPlease give the name of the other rescue group: *If you have any special requirements for a dog, please let us know so we can more carefully match a dog to your life-style:Date / Time *DateTimeSubmit
