Golden Retriever Rescue of Central Pennsylvania Adoption
Application Name
of Applicant _________________________________Age ______ Street
Address_______________________________________________ City
___________________________ State _____ Zip Code
_________ Daytime
Telephone _____________________________ Evening
Telephone _____________________________ Best
time to contact you _________________________________________ E-mail
(optional)_______________________________________________ Name(s)
of Co-Applicant(s) ______________________________________ Age(s)
_______________________________________________________ Who
will be Golden's primary care giver (if not applicant)? _____________________________________________________________ Relationship:
Spouse ______ Parent or Guardian __________ Other
(explain) ________________________________________________ Will
there be children living in the home with the Golden? _____________ If
so, how many? ____ Ages ______________________Gender_________ Is
there anyone in the home who is allergic to dogs? ___________________
Page
2 – Adoption Application Is
the pet for (circle 1) an: Adult ___ Child
___Elderly person ___ Physically
Challenged ____ How
did you learn about Golden Retriever Rescue of Central Pennsylvania? _____________________________________________________________ Are
you aware that a Golden Retriever is a large dog and may jump up and knock
down someone?__________________________________________ Do
you live in a: House ____ Townhouse ____ Apartment ____ Duplex
____ Mobile Home ___ Condominium ____ Do
you: Own _____ Rent ____ Do you have the landlord's permission to have
a dog over 50 pounds? ________ Do
you have a fenced yard: Yes _____ No ____ Fence type and height _____________________________________________________________ Where
will Golden stay during the day? _____________________________ At
night? _____________________________________________________ Is
anyone home during the day? _________ Who? ____________________ Will
your Golden have the run of the house, be in blocked-off portions of the
house, use a crate, be tied outside or live in the yard? Please be specific:
_____________________________________________________________ Will
your dog be allowed on the furniture or the bed? __________________ Is
this your first dog? _______ First Golden? __________ Are
you aware that Goldens are active and shed year-around?___________ Do
you have any other pets? _____ Types and ages? ___________________ Page
3 – Adoption Application Have
you ever sold, given away or surrendered a pet to a shelter? ________ If
so, please describe circumstances?_______________________________ _____________________________________________________________ _____________________________________________________________ Are
you aware that the routine costs of maintaining a dog average $600 to $800
annually? ________________________________________________ Name
and telephone number of veterinarian? _________________________ ______________________________________________________________ May
we contact him/her? _____________
· I hereby authorize my veterinarian to release confidential
information about my pets and my pet care. Applicant's
signature _______________________________ Date ________ Co-Applicant's
signature ____________________________ Date________ If
you have applied to another rescue for adoption, please list the name: ______________________________________________________________ Three
personal references we may contact: Name and phone number of each _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ Age
range interested in adopting: Any age _________ Adult____________ Preference:
Male _______ Female _________ No preference ___________ Page
4 – Adoption Application Would
you consider a special needs dog, such as one that requires ·
In
addition to your application please send us a detailed letter: n
About
yourselves and those who will be living with and caring for the dog n
Why
you want to adopt a Golden Retriever. If you have any special
requirements for a dog, please let us know so we can carefully match the
dog to its “forever home.” n
And
describe in detail a typical week and weekend in the life of your dog.
Please include any information about special activities in which your
rescue dog would be included. If, for any
reason, the adopter should not be able to keep this dog, he/she is
obligated to return the dog to GRRCP. _____________ Applicant’s
initials ·
At
the time of adoption, a non-refundable
$225 adoption fee is required. Additionally, a $50 obedience deposit is
also required at the time of adoption.
This money will be refunded to the adopter once proof of a
completed obedience course (taken within 3 months of adoption) is
presented to GRRCP. Obedience class is a bonding opportunity for the new
owner and Golden Retriever, offers them the chance to work through any
adjustment problems and may someday save your dog’s life. ·
Adopters
are not selected on a first come basis. GRRCP has the right to refuse
any applicant. We strive to choose the most compatible environment for
our Golden Retriever rescue dogs. Applicants
must be over 21 years of age. Applicant
______________________________________ Date__________ Co-Applicant
___________________________________ Date__________
Page
5 – Adoption Application ·
Please
mail this application along with the non-refundable $25 application fee
(made payable to Golden Retriever Rescue of Central Pennsylvania) to: Golden Retriever Rescue of Central Pennsylvania P.
O. Box 397 Centre
Hall, PA 16828 ·
Contact
can be made by calling: (814) 364-9744 or by e-mail at info@grrcp.org ·
Thank
you for your interest in giving a loving "forever home" to a
needy Golden Retriever. Once the reference checks are complete, you will
be contacted by a representative from GRRCP. The application process
takes 2 to 3 weeks to complete before a home visit can be scheduled.
Applying to adopt does not guarantee approval. FOR RESCUE USE ONLY:
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