The Dog and Ball Golden Retriever Rescue

Application for Adoption

Please complete and submit this form if you wish to adopt a Golden Retriever from The Dog and Ball. All forms are reviewed carefully. You will be notified when a decision has been reached concerning your application.

Thank you for taking the time to fill out this application. Please enter N/A rather than leaving a non-applicable line blank.

Note: Application does not guarantee adoption of a dog from The Dog and Ball.

Applicant name(s):
Primary caregiver:
Relationship to applicant:
Home Address:
City:
State:
Zip:

E-mail address:
Daytime Phone:
Evening Phone:

If there is a particular dog that interests you, please specify:

Why do you want to adopt a Golden Retriever?

Are you aware that routine costs of maintaining a dog average $700-900 annually? Y or N

Is there anyone in the home who may be adversely affected by the presence of dog(s) (allergies, etc.)? Please describe:

Names and ages of people who will be living with dog:

Do you live in a:
House
Apartment

Do you Own or Rent?
Do you have landlord's permission to have a dog over 50 lbs.? Y or N

Have a fenced yard. Type and height of fence and size of yard:

Where will the dog be kept during the day?

At night?

Will your dog have the run of the house/yard, be in blocked-off portions of the house, be crated, be tied outside or live in the yard? Please be specific:

Who, if anyone, is home during the day?

If not, how many hours will the dog be alone each day?

Will this be your first dog? first Golden?

Please list other breeds you have owned:

List all other pets you have. (m/f = male/female, s/n = spayed/neutered)

name breed age m/f s/n comments

What brand(s) of dog food do/did you use?

What types of dog treats do/did you use?

If you have ever sold or given away a pet, or surrendered one to a shelter, please describe the circumstances:

If you’ve had a pet die because of age, illness, accident or euthanasia, please explain:

Will your dog be allowed on furniture or bed?
Will you groom the dog yourself?
Use a groomer?
Will the dog be walked daily?
Exercised in fenced yard?
Be allowed to run free?

If you have owned a dog before, what type of training did you use? If this is your first dog, what do you know bout appropriate training? (please discuss potty training, discipline for chewing, barking, digging, etc.)

Please provide name, full address and phone number of most recent veterinarian(s):

I hereby authorize my veterinarian(s) to release confidential information about my pets and pet care to The Dog and Ball.

Applicant's initials: Date:

Dog Preferences:

Age

Under 3 years

3-8 yrs

senior (9+)

Gender

Male

Female

Doesn't matter

Would you consider...

a golden mix?

a special needs dog, such as one who requires medication for a permanent but controlled condition?

If you have submitted applications with another rescues, please list.

Are you looking to adopt now or later?

Please tell us about yourself and your family, including all activities in which your dog would be included.

If you have any special requirements for a dog please let us know, so we can more carefully match one to your lifestyle.

By checking here, I certify that I have completed this application with honest responses that accurately reflect my character and intended treatment of any dog I may adopt from The Dog and Ball.

Applicant’s initials: Date:

Adoption Fees:

Adoption fees help defray the costs of caring for these dogs (spaying/neutering, food, vet checkups, medical expenses, etc). Our fees are as follows:

3 mos. - 8 years: $250.00
9 yrs & older: $150.00

Fees for "special needs" dogs may be reduced or waived.

If you are interested in volunteering with The Dog and Ball Golden Retriever Rescue, please tell us your areas of interest and abilities: