Adoption Form G.R.E.AT Rescue of NE Florida, Inc. Adoption Application Name of Applicant Name of Spouse/Co-Owner Address Condo/Apt. Number City State Zip Home Phone Work Phone E-Mail Cell Phone Have you owned a Golden Retriever as an adult? Yes No If yes, how many? If not, have you owned any dogs as an adult? Yes No If yes, which breed(s)? Do you have any pets now? Yes No Please provide ALL names, ages, breeds & species. 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, describe? 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? Yes No 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? Yes No 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 a Vet’s name & phone number who will be able to provide a consistent, responsible record of your pet care. Please indicate if you will use this Vet for your GREAT Golden. If not, provide the name, phone number and fax of new vet: Tell us about yourself, your family (include children’s ages, if any), your hobbies, activities, travel and 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 SecondChoice: 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? Yes No List qualities you are seeking in your G.R.E.A.T. Golden. Would you be willing to foster a Golden Retriever until a permanent home is found for it? Yes No Maybe Would you like to become a G.R.E.A.T. volunteer? Yes No Maybe In what capacity would you volunteer? All new owners will be expected to pay an adoption fee for the preferred Golden Retriever on the day the adoption takes place. There will be no extended credit or late payments accepted. Adoption fees help defray expenses in rescuing this and other Golden Retrievers brought into G.R.E.A.T. Rescue. All G.R.E.A.T. participants are volunteers and are not responsible or liable in any manner, at present or into the future, for any problems or mishaps that may occur following the adoption of a G.R.E.A.T. Golden Retriever. The decision to place a Golden is at the sole discretion of G.R.E.A.T. Rescue and its Board of Directors and that which is deemed to be in the best interest of the Golden Retriever. We reserve the right to refuse any application. By checking this box, I acknowledge that the information presented herein is true and accurate. Further, I acknowledge that I have read the Terms of Adoption and agree to its terms.