G.R.E.AT Rescue of NE Florida, Inc.

Adoption Application

Name of Applicant Name of Spouse/Co-Owner/Partner Address  City State Zip Home Phone Cell E-Mail

Have you ever owned a Golden Retriever? YesNo If yes, how many? If not, have you owned any dogs? YesNo If yes, which breed(s)? Number of dogs owned as an adult:     Do you have any pets now? Provide ALL names & ages. YesNo Please describe

Where will the Golden be kept during the day? Where will the Golden be kept at night? Where will the Golden be kept when no one is at home? Do you have a fence? Yes No If yes, what kind? Do you work? Yes No Days & Hours? Place of Employment (Company)? Does your spouse work? Yes No Days & Hours? Spouse's name and Place of Employment (Company)?

Any children in household? YesNo If yes,  provide age(s): Do they understand the importance of caring for a pet? Yes No

Who will be the primary caregiver? Self Spouse Child(ren) Who will groom the Golden? Self Spouse Child(ren) Who will walk the Golden? Self Spouse Child(ren) Do you plan to take obedience classes? YesNo If so, where?

Are you willing to take responsibility of this pet for 10 or more years? Yes No If you move, what will you do with this Golden Retriever? Vet Reference (REQUIRED!) - You MUST provide your Vet's name & phone # . Please indicate if you will use this Vet for your GREAT Golden. If not, provide the name, ph# and fax of new vet:

Tell us about yourself, your family (include children's ages, if any), your weekly routine, and how the Golden will fit into your current lifestyle/schedule.

Describe the Golden you are seeking: First Choice: Any Puppy - Male Puppy - Female Young Adult - Male Young Adult - Female Adult - Male Adult - Female Senior - Male Senior - Female Second Choice: Any Puppy - Male Puppy - Female Young Adult - Male Young Adult - Female Adult - Male Adult - Female Senior - Male Senior - Female Would you consider a Golden mix? YesNo Would you be willing to foster a Golden Retriever until a permanent home is found for it? YesNoMaybe Would you be willing to assist in transporting GREAT Goldens on occasion? YesNoMaybe

All new owners will be expected to pay an adoption fee and perhaps some medical costs to G.R.E.A.T. Rescue to help defray expenses in rescuing this Golden Retriever and running G.R.E.A.T. Rescue. All G.R.E.A.T. participants are volunteers and are not responsible or liable in any way for any problems or mishaps that may occur following the adoption of a G.R.E.A.T. Golden Retriever. We reserve the right to refuse any applicant.

By checking this box, I, the above named, certify that the information presented herein is true and accurate. Further, I certify that I have read, understand, and agree to the Terms of Adoption.