EmailMe Form - Adoption Application

Adoption Application - SGRR

SGRR Serves the Following Areas:
Connecticut, Maine, Massachusetts, Rhode Island, Eastern New York, New Jersey, New Hampshire, & Vermont.

Nationally, Golden Retriever rescues are experiencing a shortage of dogs, yet the number of adoption applications has greatly increased. Thus, SGRR has been taking in more mixed breeds than purebred Goldens. If you are only interested in adopting a purebred Golden Retriever, SGRR is probably not the rescue group for you. Additionally, because our dogs are in high demand, 90% of our adoptions are direct adoptions from the south. If you feel you must meet a dog prior to adopting, then again, we are probably not the right group for you.

If you apply to adopt please be patient if there is a delay in processing applications - our volunteers are doing their very best. It could take some time to match you up with a dog that best suits your needs and environment. The more flexible an adopter can be with regards to age, gender, special needs, mixes, etc., the more quickly an approved applicant will likely be matched with a dog. Families with kids (must be age 10 or older), cats, and other dogs will typically have longer waits. Additionally, not every application can be chosen and we typically seek applicants with rescue experience. Thank you for your understanding!

Filling out this application on a mobile device is not recommended.

Before you begin filling out this application, we want to make sure you understand that a majority of our dogs originate in the South and are long-distance adoptions via transport from the South. While a few of our dogs are fostered in Northern homes, it is unlikely SGRR will have a dog for you if you feel you MUST meet a dog first.
Yes, I am open to a direct adoption
I need to meet a dog and understand my application will not likely be processed
Adoption Areas *
SGRR Serves the Following Areas:
Connecticut, Maine, Massachusetts, Rhode Island, Eastern New York, New Jersey, New Hampshire, & Vermont.
ADOPTION APPLICATION
After carefully considering the above information, if you would like to potentially proceed with an adoption though SGRR, continue to fill out the application.
Name *
First Last
Your Age (applicants must be at least 21 years of age) *
Name of Co-applicant
Relationship of Co-Applicant
Co-applicant Age (applicants must be at least 21 years of age)
Address *

Street Address City State / Province / Region Postal / Zip Code Country / Region
Email *
Home Phone
### - ### - ####
Cell Phone *
### - ### - ####
Cell Phone of Co-applicant
### - ### - ####
Work Phone
### - ### - ####
Applicant Employer and Occupation *
Applicant Work Schedule *
Co-Applicant Employer and Occupation
Co-Applicant Work Schedule
How many hours per day will the dog be home alone without the PRIMARY ADULT applicants, including commute time?
(We do not consider children as caretakers for the dogs.) *
What provisions will be made for the dog during these hours?
How did you hear about us?
Have you applied to any other rescue groups? *
If yes to above, have you been approved to adopt and what is the name of that rescue?
Why do you want to rescue a Golden?
What is your time-frame for adoption?
Age range of dog you would like to adopt *
Gender preference?
Preferred or required?
Dog size preferred *
Energy level desired *
Which of the following would you consider? *
Would you be interested in adopting a bonded pair?
List in order of importance the characteristics you want in a dog
Have you ever owned a dog as an adult?
Have you ever owned a Golden Retriever before?
List details about the dogs you have owned. Include the approximate date range that you owned each dogs.
Which dogs are with you presently? Include their gender and age.
What is your experience with rescued dogs?
Indicate your level of training experience.
Who will be responsible for the training?
Do you plan to enroll your rescue dog in obedience training? This is recommended for rescue dogs.
NOTE: Some dogs will benefit from the help of an experienced trainer if behavior modification is needed once your rescue dog settles in and gains confidence. Are you willing to help your rescue dog with this type of training? *
Do you own any other pets?

If yes, list details about those pets.
Are all pets spayed/neutered?
Are all pets up to date on vaccinations?
Current vet's name, address, phone number. *
Have you ever had a pet who became lost?
Have you had a pet poisoned?
Have you ever had an animal killed by a vehicle?
Have you ever had an animal treated for a disease?
Have you ever sold, given away, returned a dog, or surrendered a pet to a shelter?
IF YES, TO ANY OF THE ABOVE, PLEASE EXPLAIN IN DETAIL (YOUR APPLICATION MAY NOT BE CONSIDERED FURTHER WITHOUT ADEQUATE DETAIL)
Do you live in a house, apt, condo, etc?
How many stairs inside the house?
Are they carpeted?
Are there stairs to get into the house? How many?
Is there a second home that the dog would frequent? If so, give details & location of second home. (ie - vacation home, home of other parent)
Do you rent or own?
If you rent, give landlord contact info.
If you rent, do you have permission to keep a large dog?
Do you have a yard?
Are there stairs to get to the yard?
How many?
What is the size of your yard?
Is all or a part of your yard fenced?
If a part is fenced, is it attached to the house and fully enclosed?
Do you have a doggy door? If so, how and when is it used? *
Type of fencing - physical (style, height), invisible, etc.
If you have invisible fencing, what is your back-up plan if the dog you adopt is not trainable to stay within the boundaries of the invisible fencing?
If no fence or partial fencing, how will your dog will be allowed to exercise, play, and relieve him/herself while being kept from running away, getting lost, or getting hurt? (be as detailed and specific as possible – describe HOW you plan to do this?
How will your dog be exercised and how often do you plan to provide this exercise?
What will you do if your dog needs more exercise than you planned?
How often and under what circumstances will your dog be left unattended outside?
How often and under what circumstances will your dog be allowed to be off-leash in unfenced areas?
Do you have a tie out or runner for your dog?
If, yes, explain in detail how and when it is used.
Other than the applicant(s), how many adults in the household and relationship to applicant(s)?
How will they be involved in the care of the dog?
How many children live in the house?
What are the children's ages?
Level of children's exposure to large dogs?
Are there any children who regularly visit the home who do not live there?
Who will be responsible for the care of the dog?
Where will the dog be primarily kept?
Where will the dog be kept when no one is at home?
Where will your Golden sleep?
Is anyone in the household allergic to dogs? To other animals?
How often do you travel?
Who will care for your dog when you are away?
Are you planning to move in the near future?
When you do move, what will you do with your dog?
Does everyone in the household want to adopt a dog?
Please use this space to tell us anything about you which you think may be helpful. Please remember, only the best applications are selected for our Goldens—here is your chance to tell us why yours is one! *
What dog are you interested in adopting?
If you agree to each of the following, indicate "yes." If you do not agree to all, indicate which you do not agree to. *
Under the terms of the contract, an SGRR dog may NEVER be given away or sold and MUST be returned to SGRR in the event you are no longer able to care for the dog. *
Your rescue Golden will be kept on heartworm prevention for the first 12 months you have him/her, and as recommended by your vet thereafter. *
By submitting this form I hereby authorize a SGRR representative to verify all information provided on this form and give our veterinarian permission to disclose all medical information requested by a SGRR representative.
I understand that because most of SGRR's dogs orignate from the South, that I may not have an opportunity to meet a dog prior to adoption and I am comfortable with a direct adoption. *
If you are not comfortable with a direct adoption, SGRR may not be the avenue for you to adopt through.
The applicant will agree to not use a tie-out, runner or leave the Rescued Golden unsupervised when outdoors - which includes the use of a doggy door.
The applicant agrees to leashing the dog at all times in unfenced areas.
All of the information I have given in this questionnaire is true and complete. Should a rescue animal be placed with me, it will reside in my home as a pet. I agree to provide all necessary veterinary care, food, shelter, and love.
Is it understood that we reserve the right to remove a dog at any time should we find the adopter is no longer caring for their Golden in a way we see fit?
Are you willing to travel over 2 hours to pick up your dog?
Are you willing to allow a rescue volunteer to complete a home visit in order to approve adoption? We also require adopters to agree to follow up visits as needed.
It is understood that submission of this application DOES NOT guarantee a dog will be placed with you.
Emergency Contact *
First Last
List someone who will know how to contact you in the event we cannot reach you with the information you have provided. This should be someone other than the co-applicant.
Relationship
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Email *
Phone *
### - ### - ####
Signature
By entering my signature here, means I have agreed to all the terms in this form and agree that directors, officers, and volunteers of Sunshine Golden Retriever Rescue, operating as agents of Sunshine Golden Retriever Rescue Corp.
Signature *
Clear
To add a signature on the "Signature" field, simply do a left-click on your mouse to start writing. Click on the "Clear" link if you need to re-write the signature. Please refer to this screencast for a visual reference: https://www.screencast.com/t/wPlRgVeL
Date Time *
MM / DD / YYYY

ADOPTION APPLICATION

Signature