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APPLICANT AND FAMILY INFORMATION
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Name:
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Co-Applicant's Name
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Address:
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City and State:
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Home Phone:
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Cell Phone:
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E-mail Address:
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Applicant's Employer Name, Address & Phone Number
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Applicant's Occupation
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Co-Applicant's Employer Name, Address and Phone
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Co-Applicant's Occupation
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Name, Address and Phone for a relative who does not live with you
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Relationship to you
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List the names and ages of ALL members of your household (adults and children)
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What type of experience does each have with dogs?
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Please list the name, age, gender, breed and length of time you have owned EACH ANIMAL that currently lives in your home.
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Please check to indicate that all of the following are true. ALL CURRENT DOGS IN MY HOME:
Are spayed or neutered
Are licensed with local jurisdiction
Are up to date on vaccinations
Take monthly heartworm medication.
Use flea/tick protection.
Have seen a veterinarian in the past year.
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Please explain any of the above you have NOT checked:
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INFORMATION ABOUT HOME ENVIRONMENT
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Do you live in a (check below)
House
Townhouse
Condo
Mobile home
Other (please explain)
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Explanation of Other:
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Do you (check below)
Rent
Own
Live with parents
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Landlord Name: (leave blank if not applicable.)
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Landlord phone: (we will contact your landlord for approval if you are renting)
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What size is your yard? (sq ft.)
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Is your yard currently completely fenced- in or enclosed?
Yes
No
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Height and type of fence/wall around yard: (chain link, stone,wood). Please explain below:
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CARE OF ANIMAL INFORMATION
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Have you ever owned a Golden Retriever? Please explain your previous experience with Golden Retrievers:
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Explain why you would like to adopt a Golden Retriever. What other breeds have you considered and why?
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Does everyone in your home want to adopt a Golden Retriever? Please explain.
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Who will be responsible for daily responsibilities of feeding and taking the dog out?
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Who will provide daily exercise for the dog, how and when?
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Where will the dog be kept during the day when you are at work or away from home? (Specify location in home, access to water and shelter.)
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What is the longest period of time the dog will be left alone on a typical work day?
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Where will the dog sleep?
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Who will care for the dog when you are away on vacation?
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What are your plans for training your new dog?
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What types of training classes have you done with previous dogs?
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Have you ever crate-trained a dog? Please explain:
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Has it ever been necessary to sell or give a previous pet away? Please explain.
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With the exception of your death, what conditions or circumstances would cause you to give up a dog:
Move to another location
Housetraining issues
Destruction of property in home
Too expensive
Excessive barking
Excessive shedding
Allergies
Doesn't get along with other animals
Aggressive behaviors
Other (explain)
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Please explain any of the above concerns:
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What behaviors would be unacceptable to you?
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What actions would you take to correct these behaviors?
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What brand of dog food do you currently use or plan on using for this dog?
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PREFERENCES
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Reason for Adoption (check all that apply):
Family Companion
Personal Protection
For Child
Gift
Playmate for current dog
Replace previous dog
Provide loving and safe home for rescued Golden
Other
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Please explain any of the above:
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Preferred Gender
Male
Female
No preference
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Preferred age group: (check all that apply)
BABY or PUPPY (under 1 year)
YOUNG (1-3 years)
ADULT (3-8 years)
SENIOR (>8 years)
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Would you consider (check all that apply):
Foster parenting while waiting for the perfect dog
A Golden Retriever mix
Adopting two Golden Retrievers
A dog that must be an only pet
A dog that is is afraid of small children
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Are you willing and able to cover the care and expenses of a dog with special health needs such as (check all that apply):
Needing special diet/ supplements or exercise
Needing medication to control a chronic condition
Needing surgery or active treatment of a condition
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What type of temperament is best for your family? (check all that apply)
High energy
Active and playful
Gentle, friendly
Couch potato
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RESOURCES AND REFERENCES
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Given the cost of routine veterinary care (shots, flea/tick, heartworm medication) , premium food, boarding, grooming, licensing and occasional toys, how much do you think it will cost to care for the dog each year?
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Have you used a groomer in the past? If so, please list name, address and phone of groomer:
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Have you used a boarding kennel in the past? If so, please list the name, address and phone of the boarding kennel.
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Please list the name of your veterinarian:
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Address of your veterinarian:
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Phone of veterinarian
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Do you give your permission for Golden Retriever Rescue of El Paso to call the above individuals as references?
Yes
No
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How did you hear about Golden Retriever Rescue of El Paso? (Check all that apply):
Previous adopter referred me (list name below)
Volunteer referral (list name below)
Repeat adopter
GRREP website
Adoption event
Facebook page
Petfinder website
Adopt a Pet website
Fund-raiser
Newsletter
Other (please specify)
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Comments on above:
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Goldens are wonderful dogs. However, they are predisposed to several condition including ear infections, hot spots and excessive shedding. They need lots of exercise and attention. Without this, they often resort to other means to get attention, such as eating your slippers or digging in your garden. They can be trained to be excellent companions and excel in obedience. An adoption of a rescued Golden Retriever is a lifetime commitment to your new dog. We want both of you to be thrilled with each other and will be happy to help in any way to insure this. Please check below to indicate that you have read this statement and completed the above application to the best of your knowledge.
Yes, I have read and completed all sections
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