On-Line Adoption Application Form
Updated 07/20/08
There is a $10 non-refundable Application Fee (link opens in a new window), we reserve the right to deny an application for any reason. Application Fee does not apply to fostering. There is an adoption fee of $315.00 ($165 for a Senior Dog) for approved applicants. If you are fostering and you decide to adopt that dog, the total adoption fee will be $325 or $175 for a senior dog.
Please be very careful to answer each question, should you skip an answer, you will need to press your back button to complete the question. You may keep typing at the end of a line to complete an answer if needed.
NOTE: We may not consider applicants outside the state of Texas due to the inability to complete the home visit portion of our interview process. We do not ship or transport dogs. If you are from outside the Austin area, and wish to work with us, you must be willing to drive to Austin to meet and adopt the dog. We must have a GRR Volunteer in your area who will be able to complete the home visit portion of the application process.
Home Phone with Area Code (please use format xxx-xxx-xxxx) Work Phone Other Phone
E-mail: (if more than one put a comma with no space in between such as tim@xyz.com,tjt@abc.com)
I am interested in Adopting Fostering Either
What are your typical work hours?
Type of dwelling: House Apartment Condo Other
Do you Own or Rent your home, if Rent do you have the landlords permission to have a dog over 50 pounds? Own Rent - Have Permission Rent - Do Not Have Permission
Do you have stairs, if yes, how many flights of stairs? Do you have an elevator?
Attention Renters: A copy of your lease, or a notarized statement from landlord confirming a large (60-100#) dog is permitted must be submitted to GRR, PO Box 956, Austin, TX 78767-0956, or fax (512) 301-3475 prior to the scheduling of the home visit . Landlord's Name: Landlord's Phone:
Attention Renters: A copy of your lease, or a notarized statement from landlord confirming a large (60-100#) dog is permitted must be submitted to GRR, PO Box 956, Austin, TX 78767-0956, or fax (512) 301-3475 prior to the scheduling of the home visit .
Landlord's Name:
Landlord's Phone:
Do you have a fenced yard? Yes No
Number of Adults living in household Select Number 1 2 3 4 5 6 7 8 9 10 11+
Ages and sex of adults living in household
Number of children living in household Select Number None 1 2 3 4 5 6 7+
What are the ages and sex of children living with you or frequently visiting?
Are any residents allergic to animals or dander? Yes No
Do any residents have asthma? Yes No If Yes, how is it controlled?
Why do you want a Golden Retriever?
What type of dog are you looking for? (check all that apply or No Preference)
Age Preference:
0-6 Months
6-12 Months
1-2 Years
3-4 Years
4-5 Years
5-7 Years
Senior (7+) years
No Preference
Energy Level Preference:
Couch Potato
Average
High
Sex Preference:
Only Male
Prefer Male
Only Female
Prefer Female
Have you ever bred dogs? Yes No Do you plan to breed dogs? Yes No
What pets do you currently own? List the type, age, and sex of each pet:
Pet #1 Name
type
age
sex Male Female
How long have you owned this pet?
Spayed or Neutered Intact Spayed Neutered
Pet #2 Name
Pet #3 Name
Pet #4 Name
Have you ever owned a dog? Yes No If yes, please list the dog(s) breed, ages, sex and what happened to them:
Where will the dog be during the day while you are at home?
Where will the dog be during the night?
Where will the dog be when left home alone (example: at work, running errands, etc.)?
Number of hours dog will be alone each day ?
How will the dog be exercised?
Who will care for your pet when you and your family are out of town?
Are there any special activities the dog would participate in (Hunting, Running, Hiking, Swimming, Camping, etc.)?
Are you willing to consider a special needs dog (i.e. blind, deaf, thyroid medication, etc.)? Yes No
Have any of your pets ever been diagnosed positive for heartworms? (if this does not apply, please answer no) Yes No If you move what will you do with your pet?
Do you have a current Veterinarian? Yes No If yes, Please provide the following information:
Clinic Name
Address
City
Phone (format 512-xxx-xxxx)
Is there a dog you found on our web page that you think most matches with your needs?
Is there anything else you would like us to know in considering your application?
What other rescue groups are you currently working with:
What other rescue groups have you worked with in the past:
Are you prepared to provide for the dog for the next 10 or more years? Good dog care in our area can cost $1200 annually. This includes annual vet care, inoculations, parasite testing, monthly heartworm & flea preventative, quality dog food, toys, miscellaneous equipment, boarding/kennel fees, grooming and other supplies. This does NOT include any injuries, or illnesses the dog may incur.
Will you spend this to support a dog? Yes if no, please do not submit this application.
How did you hear about Gold Ribbon Rescue Select Internet (specify below if by search engine or how you found us) Newspaper Petfinder.com Friend Yahoo pets Other If Internet or Other please describe:
Is this application for Select Fostering Adopting ?
Pressing the submit button below will begin the application review process. Please be sure before you Submit your application, you have paid the non-refundable $10 application fee? The application fee is non-refundable whether or not you are approved and GRR reserves the right to refuse any applicant.
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