The * denotes required fields
CONTACT INFORMATION

* Applicant's First Name: *Last Name:
Co-Applicant's Name:
* Address:
Mailing Address (if different):
* City: *State: *Zip:
* Home Phone: Work Phone:
Work Hours:
* Email Address:
Please, only ONE email address!


GENERAL QUESTIONS

* Do all family members want a golden rescue?

* Are you willing to come here to pickup your Golden Rescue?
Please Note: We are a volunteer organization working to rehome as many goldens as we possible can. Because we are a volunteer group, there are no funds for transporting a golden rescue to your home and usually not enough volunteers to arrange CUR runs. We are willing to provide you with contacts to arrange a CUR on your own; but ultimately, you need to be responsible for the transportation of your new golden rescue to your home.


* How did you learn about TVGRR?

INFORMATION ABOUT YOUR HOUSE AND YOUR HOUSEHOLD

Please list all the members of your household with their ages, including your pets
Humans-Name:








 Age:








    Cats-Name:(if none, leave blank)
 Age:

Please list all the members of your household with their ages, including your pets
Dogs-Name:
(if none, leave blank)		 Age: Breed: Gender:



Please list all other pets
Other Pet Types:
 Age:
What Happened to the Pet:


If you do not have small children living in your home, will your Rescue Golden come into regular contact with any children under the age of 10? If yes, how often and what ages?

How Often?
Ages of Children:


If you do not have a dog now, have you ever owned a dog for whom you were the primary caretaker? Please Specify
BreedGender

* Does anyone in your house have allergies?
If Yes, to what allergies?

* Is your home a: House Condo/Townhouse Apartment
* Do You

* How long at current residence

If you rent, has your landlord provided written permission for you to have a large dog?


* Do you have a fenced yard? fence length: fence width: fence height:

If you don't have a fence, are you willing to install one?

INFORMATION ON THE CARE OF YOUR GOLDEN

* Who will care for, train and exercise the Golden Rescue?

* Who is the Golden Rescue primarily for?
* *Who is your Veterinarian? (If you have recently changed vets (within the last year), please provide us with your previous vet's name and phone number.) * Vet Phone Number
* Vet Address:


* Why do you want a Golden Retriever Rescue?
* How will you exercise your Rescue Golden?
* Where will your Rescue Golden be kept during the day?
* How many hours per day will your Rescue Golden be alone (without humans) on a regular basis?
* Where will your Rescue Golden sleep at night?

* Will the golden rescue be allowed in the house?
* Will the golden rescue have the run of the house?

* Are you familiar with the use of a crate to train and/or confine the pet during your absence or at night?
* Are you willing to use a crate?

* Will the golden rescue be in blocked-off parts of the house?
* Will the golden rescue be tied outside?
* Will the golden rescue live in the yard?

* Will the golden rescue be walked daily?
* Will the golden rescue be Exercised in a fenced yard?
* Will the golden rescue be allowed to run free outside of a fenced yard?

* Will your golden rescue receive formal obedience training?
If Yes, please identify the obedience trainer?

* When you move, what will you do with your Golden?

* Why do you think you would be a good adopter for a Rescue Golden?


MISCELLANEOUS QUESTIONS

* May we visit your home prior to application approval?
If Yes, when?

* Are you aware that Golden Retrievers are active and shed all year long?
* Will you groom your golden or use a groomer?

* Are you aware that routine costs of maintaining a Golden Retriever average $500 a year?

* Have you sold, given away, or surrendered a pet to a shelter, pound, Humane Society or individual?
If Yes, please provide details?

* Do you understand the state and local ordinances concerning licensing?
* Leashing?

* Have you or any member of your family/household been cited for leash law violations or animal cruelty?
If Yes, please provide details?

* Have you applied to any other Golden Retriever Rescue Groups?
If Yes, please identify the group(s) so that we do not duplicate their effort(s)?

PREFERENCE QUESTIONS
Preferences - Mark all Applicable
(Please note - you will be contacted when a golden rescue becomes available, even if all preferences are not met. You will have the ability to personally evaluate any golden rescue prior to accepting one into your home.)


* Age preference:
*Color preference:
*Activity preference:
* Sex preference:
* Purpose: Family Pet    Obedience    Hunting   
*

Would you consider a Special-Needs Golden such as one who requires medication for a permanent but controllable condition?

* Would you consider a Golden Mix?
Additional Comments?

AGREEMENT


Agreement
TVGRR is a non-profit volunteer organization working to rehome Golden Retrievers. Our primary purpose is to find appropriate, loving, long-term homes for these Goldens. TVGRR reserves the right to deny any adoption for any reason.

If the above applicant is approved by TVGRR as being eligible for adopting a TVGRR Golden, the following will be agreed to by the applicant:

  •  
    		• I/We attest that the Terms and Conditions of Adoption as stated below have been read in full by me/us and I/we understand that is part of the adoption process and will be enforced.
  •  
    		• I/We attest that the information provided on this application is true and accurate to the best of my/our knowledge.
  •  
    		• I/We attest that we have retained a copy of the Terms and Conditions of Adoption and also understand that completion and submission of this application does not guarantee adoption of a Golden Retriever.
  •  
    		• I/We agree to notify TVGRR to discontinue searching for a golden rescue on our behalf if I/we find a dog elsewhere.
  •  
    		• I/We agree to pick up or make arrangements for pickup of my Golden Retriever once the application has been approved and an appropriate dog selected.
  •  
    		• I/We agree that the Golden Retriever acquired through TVGRR is to be returned to TVGRR should I/we not want or can no longer take care of the animal or are unable to retain possession of the golden rescue.
  •  
    		• I/We agree to notify TVGRR in the event that such circumstances occur that I/we feel our Golden Retriever must be euthanized. If the circumstances involve an accident or illness, on the part of the Golden Retriever, such that the golden rescue is in so much pain that immediate euthanization is necessary, I/we agree to notify TVGRR as soon as possible after the fact.
  •  
    		• I/We agree to be personally responsible for the humane care- proper food, water, shelter, regular exercise, veterinary care, and control of their TVGRR Golden at all times.
  •  
    		• I/We agree The TVGRR Golden will be spayed or neutered prior to entering the applicant's home or at the first medically possible time
  •  
    		• I/We agree TVGRR can make no warranty about the health condition or temperment of this golden and that TVGRR can only provide information based on observations at the shelter and/or statements from the previous owner.
  •  
    		• I/We agree the TVGRR Golden shall not be tied out (chained, roped, etc.) at the applicant's home for extended periods of time.
  •  
    		• I/We agree if determined by TVGRR that any TVGRR golden rescue is not receiving proper care or that city/county laws or ordinances are violated, TVGRR may take the golden rescue from the applicant.
  •  
    		• **I/We agree to TVGRR contacting my current and past Veterinarian(s) to verify my current/past pets have received proper care and treatment including but not limited to, necessary and required shots and heartworm preventative.
  •  
    		• I/We agree to pay the requested adoption fee to aid in covering the costs associated with rehoming golden rescue.
  •  
    		• All of the information provided to TVGRR by the applicant is correct.
     



    I as stated above (please select)



    **Please hit the Submit Button only once**

    Please Note: It takes time to process the application after submission.