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Adoption Application

Thank you for your interest in adopting from GRRA™. If you can provide the special home a Golden Retriever deserves, we hope to be able to match you with a dog that will be a wonderful addition to your family.

About the Process

The GRRA™ application process is as follows:

Please complete and submit the application form below. There is a $20 non- refundable application fee. Once you have submitted the application, you will have the option of making a secure online payment through PayPal or you may pay by check. Checks should be mailed to:

Golden Retriever Rescue of Atlanta™
P.O. Box 3907
Peachtree City, Georgia 30269

After your application and payment are received, an Adoption Consultant will telephone you to explain the GRRA™ adoption process and help you determine what dog attributes are best suited for your home.
The Adoption Consultant will also arrange for a GRRA™ volunteer to visit your home. This home check is an important step in our process as it ensures that each dog is placed in the best home to meet its specific needs.
Your Adoption Consultant will inform you of available GRRA™ dogs that may be potential matches and will arrange for you to meet with the dogs and Fosters.

Adoption Fees

Effective November 15, 2011 the Adoption fees for GRRA™ Golden Retrievers will be as follows:

Golden Puppies 6 months or younger - $450
Goldens over 6 months to six years of age - $350
Goldens between seven and nine years of age - $250
Senior Goldens (10+ years of age) - $150

Current adoption fees for GRRA™ Golden Retrievers are as follows:

Goldens six years of age or younger are $325
Goldens between seven and nine years old are $250
Senior Goldens (10+ years of age) are $100

Additional Information

GRRA™ primarily accepts adoption applications from and places Golden Retrievers in the North Georgia region, within approximately a 100-mile radius of metro Atlanta. Applicants living outside of this area are advised to contact GRRA™ by sending a message to placement@grra.com prior to submitting an adoption application, as we may have limited or no placement volunteer resources in their area.

If you reside outside of Georgia and are interested in adopting a rescued Golden Retriever, please refer to www.grca-nrc.org for a listing of Golden Retriever rescue groups in your area.

GRRA™ reserves 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). Your answers on this application will help us find the best possible match between you and a Golden Retriever in our program. 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: