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NOTE: Golden Rescue In Naples, Incorporated is able to accept applications only from persons

Name________________________________________________________________Age____________

Address______________________________________________________________________________

City____________________________________________State______________Zip________________

Daytime Phone______________________________Evening Phone______________________________

Best time to call_______________Anyone home during the day?___________Who?________________

When will you actually be ready to adopt?___________________________________________________

Rescued goldens vary in age. What age will you consider? ____0-3 years ____3-6 years ____any age

Do you prefer: _____ Male _____ Female _____ No preference (All rescues are spayed/neutered.)

Would you consider a special needs golden, such as one that may require medication for a permanent but

_____ Very energetic _____ Somewhat energetic _____ Average _____ Quiet _____ Very Quiet

Are there children in your home? _____ Yes _____ No Grandchildren who visit? _____ Yes _____ No

If yes, what kind and age? ________________________________________________________

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In no, please explain: ____________________________________________________________
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Please state the names and ages of other people who will be living with the dog. ____________________

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Is the dog for an: _____ Adult _____ Child _____ Elderly Person ____ Physically Challenged Individual

Age and sex of children in the home: ______________________________________________________

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If yes, how long ago did they have a dog? ____________________________________________

Have the children been taught to respect an animal as a living thing and not as a toy? ____ Yes ____ No

Rate your children’s behavior with pets: _____ Excellent _____ Good _____ Fair _____ Unknown

Do you live in a: _____ Single Family House _____ Condo _____ Apartment _____ Duplex

(If you rent, you may be asked to provide a letter from the landlord stating that this dog is allowed to live in your home.)

Do you own this property? _____ Yes _____ No _____ Rent? _____ Lease/Option to buy?

How will the dog be managed when outside? ________________________________________________

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Do you have a completely fenced-in yard? _____ Yes _____ No Partially Fenced? Please explain

If the dog will have access to a fenced-in yard, what is the fence type and height? ___________________

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Approximate yard size: _________________________________________________________________
Will this dog be allowed to remain outside while you are not home? _____ Yes _____ No

If yes, please explain: ____________________________________________________________

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Is your home adjacent to a pond, lake, canal or other body of water? _____ Yes _____ No

If yes, will this dog be allowed to swim in the body of water? _____ Yes _____ No

Where will the dog be kept during the day? _________________________________________________

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Where will the dog sleep at night? ________________________________________________________

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What will you do with your dog when you are on vacation? ____________________________________

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Have you had other pets before? _____ Yes _____ No A dog? _____ Yes _____ No

If yes, what kind and when? ______________________________________________________

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Is this your first “Golden Retriever”? _____ Yes _____ No

Why did you choose a golden? ___________________________________________________________

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Have you ever sold, given away, or put a pet into a shelter? _____ Yes _____ No

If yes, please explain:_____________________________________________________________

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Does anyone in your home have allergies to pets? _____ Yes _____ No

Will you use a crate? _____ Yes _____ No

How will you provide the exercise that this dog requires? ______________________________________

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Do you plan to train your dog yourself, take him/her to an obedience school or use a professional trainer?

If you plan to take your dog to an obedience school, which one? ________________________________

_____________________________________________________________________________________Please list the name, addresses and PHONE NUMBERS (required) of any previous vets you’ve used.

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Please list the name, address and PHONE NUMBER (required) of your current vet, the vet you will use with this dog. __________________________________________________

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May the vets (individuals) you have listed on this application be contacted regarding past or present pets?

_____ Yes _____ No If no, please explain: _________________________________________

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May the vets (individuals) you have listed on this application be contacted regarding any dog you may

obtain through Golden Rescue In Naples, Inc.? _____ Yes _____ No

(We will be in touch with you periodically to answer any questions that you might have and to ensure that both you and the pet are getting along well.)

How did you find out about Golden Rescue In Naples, Inc.? ____________________________________

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If you were referred, by whom please. _____________________________________________________

When are you actually ready to adopt/foster a golden? ________________________________________

You are welcome and encouraged to include information in the space below that will assist the processing of your application. Please … tell us about your family! Please use additional pages if needed

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Page 4 of 4

The Golden Retriever is a wonderful dog; however, they are predisposed to several conditions: ear infections, hot spots, excessive shedding, and generally a need for lots of exercise in order to be good house pets. They are not outside dogs to be tied or enclosed away from “their people” and can become quite loud, destructive, and even self-mutilating if made to live in these conditions. Many require a good amount of attention, and when not given the attention they wish, will resort to tearing up your favorite slippers, gardens, etc. in order to get your attention. Golden Retrievers are known to be in-your-face and velcro dogs! These dogs are excellent obedience candidates and can be easily trained to be wonderful companions – if you will work with them. Obedience is obtained by being fair and consistent, and offering praise when the deed is obtained. To train a dog, you have to think like a dog. Hitting, etc. is considered an aggression by the animal and eventually the animal may retaliate.

This pet will cost approximately $150.00 a year in vet bills and $180.00 to feed. Additional expenses may include grooming, collars, leads, bowls, and toys. We want both of you to be thrilled with each other and would be glad to help in any way to ensure this. Just call: (239) 514-2715.

Questions pertaining to the animal’s being allowed on the furniture, whether you have fencing or not, etc. are to ensure that you will get a dog you can live with. Most dogs will need a fenced yard, and some dogs that have previously been allowed on furniture might be a constant struggle for you, if you do not wish to allow this to continue. Your answers will not, however, jeopardize your application.

ADOPTION FEES: $275.00 for dogs up to 2 years, $225.00 for 2-8 years, and the adoption fee for above 8 years will be $125.00, mixed breeds, base fee of $125 and reimbursement of major medical expenses not to exceed $225. These donations help us meet the veterinary, boarding, and foster care expenses incurred by this nonprofit organization…although our average expense per Golden is greater than the adoption donation.

I have read and completed the above to the best of my knowledge and agree to the conditions herein.

Signature:__________________________________________________Date:______________

Co-Applicant Signature: _____________________________________ Date:______________

Golden Rescue In Naples, Inc., dogs have all received current veterinary care: rabies update, DHLP update, fecal exam, heart-worm exam, and initial heartworm protection, spay/neuter, bordetella vaccine and other tests as indicated, and a general health check-up. You will, however, need to purchase additional heartworm preventative for year-round use.

· The cost of Golden Rescue In Naples, Inc. dogs varies due to age and medical history/conditions.

· Special needs dogs will be placed free of charge into caring and loving homes.

· Adoption fees are payable by, Cashiers Check, Money Order or Cash and accepted in US funds only. Cashiers Checks and Money Orders should be made payable to: Golden Rescue In Naples, Inc.

Thank you for your application. We will process it as quickly as possible. Allow approximately 1 to 2 weeks.

ADOPTION / FOSTER APPLICATION

PLEASE RETURN YOUR COMPLETED APPLICATION TO: