TRIAD GOLDEN RETRIEVER RESCUE ONLINE APPLICATION
Non-refundable Application Fee. Please enter your check number and date of check in the Application Fee box.
Application Fee:	(Please enter both check # and date of check)
Application does not guarantee adoption of a dog from TGRR. Your application will be reviewed once the fee has been received and you should be contacted within 2 weeks after the check clears.
Applicant 1:	(Please enter both first and last name)
Applicant 2:
Email 1:		Email 2:
Address:
City:
State:	ALASKA ALABAMA ARKANSAS ARIZONA CALIFORNIA COLORADO CONNECTICUT DISTRICT OF COLUMBIA DELAWARE FLORIDA GEORGIA HAWAII IOWA IDAHO ILLINOIS INDIANA KANSAS KENTUCKY LOUISIANA MASSACHUSETTS MARYLAND MAINE MICHIGAN MINNESOTA MISSOURI MISSISSIPPI MONTANA NORTH CAROLINA NORTH DAKOTA NEBRASKA NEW HAMPSHIRE NEW JERSEY NEW MEXICO NEVADA NEW YORK OHIO OKLAHOMA OREGON PENNSYLVANIA RHODE ISLAND SOUTH CAROLINA SOUTH DAKOTA TENNESSEE TEXAS UTAH VIRGINIA VERMONT WASHINGTON WISCONSIN WEST VIRGINIA WYOMING	Zip:
Home Phone:
Work Phone 1:		Work Phone 2:
Cell Phone 1:		Cell Phone 2:
How did you learn about TGRR?
If Internet or web search
Pet Finder   Other
Gender Preference:
Male   Female   No Preference
Additional Preferences:
Reasons for wanting a Golden:

FAMILY STRUCTURE & LIFE-STYLE
Do you Rent/Own:	Rent Own
Do you live in a house/townhouse?	House Townhouse
If you rent, do you have your landlord's permission to own a dog?	Yes No
Fence Information
Do you have a fence?	Yes No
If so, is it attached to your home?	Yes No
What type of fence is it?
What is the height of the fence?
Is it secure?	Yes No
Family Life
Where will the dog stay during the day?
Where will the dog sleep?
Where will the dog exercise?
Do you have children at home? If so, what ages?
Are they comfortable with large dogs?
Who will be responsible for taking care of this dog?
How many hours would your dog be alone on an average day?
Does anyone in your family have a problem with allergies or dog hair?
Other Pet Experiences
Have you owned a pet before?	Yes No
What kind?
What happened to it/them?
Was your previous dog an inside pet or an outside pet?	Inside Outside
What other pets do have you have now?
If your pets are dogs, what is the gender?
Have they ever played with or been exposed to other dogs (socialized)?	Yes No
What were their reactions?
How do you or would you discipline your dog?
Have you ever obedience trained a dog?	Yes No
Would you let the dog off the leash outside of a fenced area?	Yes No
Where will dog stay when you go on vacation?
Who is your regular vet?
Phone:
Are you willing to take responsibility for a dog for the next 10 or more years, including annual vet checks, vaccinations, boarding, medical care, food?	Yes No
Would you consider adopting a senior or special needs Golden?	Yes No
Have you sold, given away, or surrendered a pet to a shelter, rescue group, or the Humane Society?	Yes No
If yes, please explain:
Have you applied to any other Golden Retriever Rescue groups?	Yes No
If Yes, please specify the group(s) so that we do not duplicate their efforts:
Please add any additional information or comments below.
If you live outside the Triad area of NC a letter of recommendation from your current veterinarian will be required. Your application will be acknowledged and a phone interview maybe conducted, but your application will be considered incomplete until the required reference letter is received.