Adoption Application

We do not adopt outside of Colorado and Wyoming. Sorry. Thank you!
Applicant

First Name      Last Name

Street     City     State

Zip      Email      Age

Primary/Home Phone      Work Phone

Cell Phone      Best Contact Time

Occupation      Weekday Schedule

Co-Applicant

First Name      Last Name

Age

Household

Do you live in a House Townhouse Apartment Duplex Condo

Do you own or rent? Own Rent

If you rent, please answer the following questions

Is anyone home during the day? Yes No

Do you currently have children at home? Yes No

Age and gender of other people in the household (full or part-time):

Please list other regular visitors, children, or animals with which your new dog must get along?

Pets

Do you currently have a dog(s)? Yes No

Do you currently have a cat(s)? Yes No

PLEASE NOTE: We cannot guarantee that all dogs in our program are compatible with cats. If the foster home did not have cats we cannot be certain. GRFR will provide information to the adopter on how to introduce dogs and cats. It is up to the adopter to follow safety procedures when introducing the new dog to family cats in order to reduce the risk of injury to cats in the home.

List your current pets, their ages, and if they are spayed or neutered

Have you ever owned a Golden Retriever (or other dog) before? Yes No

Facilities

Do you have a fenced yard? Yes No    If yes, please provide its height and a brief description.

PLEASE NOTE: A fenced yard is generally required for Goldens under 8 years of age.

Do you have a dog house or a dog kennel in your backyard? Yes No

Will you use a chain, tie out, or cable runner to restrain your dog outside?
Yes No

Where will you keep your new Golden when you are away from home for work, errands etc. on a typical day (inside, outside, both, both with dog-door, etc )?

Do you have a dog door?
YesNoN/A

Where will your new Golden sleep at night?

Care / Training

How will you exercise your dog?

Are you familiar with crate training? Yes No

Will you crate train your new Golden? Yes No

Will you take your new Golden to obedience class? Yes No

Please provide the name, address, and phone number of your current vet along with current or previous pets' names.

Preferences

What age range are you considering?
0-6mo    7-23mo    2-3yr    4-5yr    6-7yr    8-9yr    10+yr    No Preference

PLEASE NOTE: A Golden Retriever's nature is that of very high energy and they require a great deal of exercise, especially under the age of 3. If you do not have another dog, are not highly active, and do not have a lot of time to spend training and caring for the dog, you will have an unhappy dog and you will not be happy either. Please DO NOT check age 0-6mo, 7-23mo, or 2-3yr if you do not want a high energy dog. There is no such thing as a mellow Golden puppy so don't believe it! Call any organization that uses Goldens to help the blind or disabled and ask them if you need confirmation!

Do you prefer: Male Female Either

Why?

Would you consider a mix? We only take friendly mixes, like goldens/labs.
Yes No

Would you consider fostering until the appropriate dog for you came along? (Our wait time varies - it could be one week or it could be several months.)
Yes No

Would you consider a special needs dog such as one who requires medication for a permanent but controlled condition?
Yes No

How long are you willing to wait for a rescue dog?

If you have a preference on age or gender, please explain, along with any other special requirements or preferences so that we can match you with the most appropriate dog.

Additional Information

Who will be primarily responsible for this dog?

What circumstances, in your opinion, could justify returning your new Golden to GRFR?

Please provide us with a reference, either a neighbor, friend, or relative.
Name:

Phone:      Relationship:

Please tell us about yourselves and why you want to adopt a Golden Retriever. We would like to hear about what type of lifestyle a dog from our program would have if placed in your home and how your Golden would fit into your daily activities. Please provide as much information as possible so we can ensure an appropriate match with a rescue Golden. If you have never owned a Golden, why have you decided on one now?

When will you be ready for a new dog?

Submission of your application does not guarantee placement of a Golden Retriever. GRFR reserves the right to reject any application for placement. Applicants must agree to a home visit prior to adoption approval.

The placement fee for a Golden Retriever is due at the time of placement. The placement fee ranges from $175.00-$350.00 which covers the cost of medical treatment (spay/neuter, rabies, parvo/distemper vaccinations and heartworm check for out of state dogs) and transportation. For puppies who are 6 months of age or younger, the placement fee is $350.00 and covers the first round of puppy shots, rabies and spay/neuter. It is extremely rewarding to have people who are willing to make the last years the best years for our senior dogs. For senior dogs, age 8 years and older, the placement fee is $175.00. For all other dogs, age 7 months to 8 years old, the placement fee is $300.00.

Your application will not be submitted until after you enter the Security Code and click the Submit button below! By clicking the Submit button you affirm your acceptance of the terms above.


Please enter the Security Code shown above (five characters, a mixture of alphabetic and numeric, no blanks, alphabetic characters are displayed in upper case but may be entered in either case, the displayed symbol for zero has a dot in the center).

This form is "sticky". If you mistype the Security Code, or fail to enter a required field, the form will be redisplayed with error messages at the top in a large bold font, but your input will be preserved. If your form is accepted, "Thank you <your name>" will be displayed in a large bold font at the top of the form



The following information should be read now, but is not signed until your new Golden has been placed with you.

I ACKNOWLEDGE THAT ALL THE 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 PLACED DOG FROM MY HOME BY GRFR.