GRRA - Golden Retriever Adoption Application

Adoption Application

Thank you for inquiring about adopting a Golden or Labrador Retriever. If you can provide the special home a Golden or Labrador Retriever deserves, we hope to be able to offer you a dog that will be a wonderful addition to your family.

The procedure for applying to adopt a dog is as follows:

1. Please complete the application below and submit it to us. There is a $20.00 non-refundable application fee. Once you have submitted the application, you will be presented with the option of paying the fee via credit card or check. Checks should be made payable to Golden Retriever Rescue of Atlanta™, Inc. Under special circumstances GRRA may accept applications from individuals living out of state. If you reside outside Georgia and are interested in adopting a rescued Golden Retriever, you should refer to www.grca-nrc.org for a listing of groups in your state.

2. After your application and payment are received, an adoption consultant will telephone you to discuss Golden and Labrador Retrievers in general, what to expect when working with GRRA™, and what type of dog your family desires.

3. The fee for the adoption of a Retriever less than seven years of age is $300.00 and $250.00 for retrievers seven years of age or older.

4. We reserve the right to refuse an applicant at our sole discretion for any reason (including but not limited to if we believe that the home situation is not compatible with the needs of a Rescue Retriever).

We have successfully placed hundreds of Golden and Labrador Retrievers in loving homes. Their ages generally vary between twelve months and seven years; however, we have also placed many seniors and puppies as well. All Rescue Goldens and Labs have had a physical exam, are neutered or spayed, immunized, and heartworm tested (unless they are too young at the time of release for one or more of these). Most dogs come to us from shelters and then from owners where there has been a move, a divorce, allergies, or just not enough quality time to spend with the dog.

Our organization is comprised of hard-working volunteers whose only reward is seeing these wonderful Goldens and Labs placed in their forever loving homes.

The answers you give on this application will help us find the best possible match between you and a Golden or Labrador Retriever that might be available through GRRA™. The completion of this application does not in any way guarantee that we will place a dog with you.

Personal Information
Salutation:
First Name:
Last Name:
Other Family First Names:
Email Address:
Occupation:
Name of Employer:

Address Information
Street Address:
City:	State:	Zip:

Phone Numbers
Home Phone:		Work Phone:
Fax:		Mobile Phone:
Best time to call:

Reference Information
Personal Reference:
Relationship:
Reference Phone Number:

Home Environment Information
Do you live in a:
Do you own or rent:
If you rent, do you have your Landlord's written permission to have a large dog on the property?:
Landlord Name:
Landlord Phone:
How long have you lived at this address?:
If less than one year, provide previous address:
Do you have a fence?:
Describe the height and type of the fence:
If no fence, how will you handle the dog's exercise and toilet needs?:
How many adults are in the household?:
How many children are in the household?:
What are the ages of the children?:
Is anyone allergic to dogs or dog hair?:
Will you be willing to let a GRRA™ representative visit your home?:

Animal Ownership Information
Have you ever been cited by Animal Control?:
Have you ever owned a dog?:
Have you ever owned a rescue dog?:
What breed was the rescued dog?:
How was the rescued dog obtained?:
Provide a history of each dog ever owned:
What animals are currently in your household?: (List pet / breed / sex / age)
What is the name of your current vet?:
What is the name of the vet clinic?:
What is your vet's phone number?:
Where will your retriever spend the day?:
Where will your retriever spend the night?:
On average, how many hours a day will the retriever be left alone?:
Will you enroll the retriever in obedience training?:
What type of retriever do you want?:
Do you prefer a male, female or either retriever?:
We suggest you look at both males and females as each retriever is unique. Either will make an excellent pet.
Do you have a preference in the dogs age? (This will assist the Adoption Consultant in helping you find the Retriever which is right for you):


Name of person applying for the dog:

State of Georgia regulations require that we record the driver's license of the applicant on the application.
Please enter the applicant's Drivers License number:

* MANDATORY FIELD; YOU MUST MAKE ONE CHOICE TO PROCESS YOUR APPLICATION
All applications require a $20 non-refundable application fee. How will you pay the application fee?

How did you find out about GRRA™?
Internet:		GRRA™ Event:
Advertising:		Vet:
Newspaper or Magazine:		Other Referral:

All of the information I have given in this Adoption Application Form is true and complete. The Golden Retriever or Lab will reside in my home as a pet. I will provide it with food, shelter, water, training, affection and medical care including monthly heartworm preventative. I understand that I must consent to an interview and a home inspection before my application can proceed, and do so consent by submitting my application below. I understand and agree that GRRA™ may refuse my application for any reason in its sole discretion, and I hereby agree not to sue or take any similar action against GRRA™ in the event my application is not approved or for any other reason related to this application. If my application is approved, I understand that it is my responsibility to see and evaluate the dog for myself before agreeing to adopt it. I understand that prior to adopting any dog from GRRA™, I must sign a mutually acceptable Adoption Certificate and Indemnification Agreement, which form shall be provided by GRRA™.

By submitting below, I agree to the terms of this Adoption Application Form.

Click the submit button to send your application to GRRA™:

For GRRA™ Use Only: