I attest all information I provide below is true. I promise to care for a Golden Retriever to the best of my ability, with the full intent of keeping the dog for the duration of its life. I also agree to keep a quick release collar with tags on the dog, provide quality dog food, adequate shelter, veterinary care and training as needed. GRRR requests a donation of $250 (Seniors age 9 and over are $150 and puppies are $325 plus $100 deposit for spay/neuter) at the time of adoption to help cover GRRR's expenses.

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Name *
E-mail Address *
Please share your occupation *
Co-applicant's name
Please share co-applicant's occupation
Street address *
City *
State *
Zip code *
Home phone *
Work phone
Mobile phone or alternative phone to reach you
How did you hear about Golden Retriever Rescue of the Rockies? *	Word of mouth Have adopted from GRRR before Veterinarian A GRRR member Web search Newspaper Shelter Other Rescue Group Link from another Web site Golden Breeder or Breed Club All Breed Rescue Network Other
If you have adopted from us before, please tell us when and any info about your dog(s) you would like to share with us.
Age of applicant(s)
Do you rent or own your home	Own Rent
What is the youngest dog you will consider? *
What is the oldest dog you will consider? *
Please indicate your preference for the dog's gender. *	Either Male Female
Do you require an AKC registered dog? *	Yes No
Would you accept a mixed breed? *	Yes No Maybe, depends on mix
What activities would the dog be participating in, e.g., jogging, hiking, hunting, agility, service dog, obedience competition, etc.?
What type of fence do you have? *	No fence Chain link Wood Dog pen Electronic (invisible fence) Electric fence Rod iron Split rail Split rail with mesh fencing
Height of fence (choose size closest to actual fence height) *	N/A 3' 0" 3' 3" 3' 6" 3' 9" 4' 0" 4' 3" 4' 6" 4' 9" 5' 0" 5' 3" 5' 6" 5' 9" 6' 0" or more
If you do not have a fence, please describe your plans on controlling your dog outside without a fence.
Where will the dog spend its time during owner's working hours? *	Outside home Inside home Both (depending on weather) Inside with dog door to outside Crate Dog pen Acreage Garage At work with owner
Where will the dog sleep at night? *	Crate Inside home Outside home Dog pen Garage
On average, how many hours per day will the dog be left alone? *	12 11 10 9 8 7 6 5 4 3 2 1
Will the dog be crate trained? *	No Yes Maybe Depends on individual dog
Will the dog be taken to obedience class? *	No Yes Maybe Depends on individual dog
What are the ages of your children? *
What other pets do you own? *
Are your other pets spayed or neutered?	Yes No
Under what circumstances would you give up any of your pets?
Names of dogs on website that are of interest
Have you ever owned or lived with a dog before? *	Yes No
Have you ever owned a Golden Retriever or Golden Retriever Mix before?	Yes No
If you have owned a dog before, please provide the name and phone number of your veterinarian.
Please list three references (no family members please) with phone numbers *
Additional information you would like for us to know.
Would you consider a dog with special needs or a medical condition that is controlled with medication	Thyroid Arthritis Allergies We prefer to not adopt a dog with special needs Other (please explain in comments)

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Golden Retriever Rescue of the Rockies :: Phoebe's Place :: 15350 West 72nd Avenue :: Arvada, CO 80007
(303) 279-2400
GRRR is a registered 501c3 charitable organization