PO Box 25391, Portland, Oregon 97298-0391
Voicemail: (503) 892-2897
Email: goldenbondrescue@yahoo.com
www.goldenbondrescue.com
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Golden Bond Rescue of Oregon, Inc.
PO Box 25391, Portland, Oregon 97298-0391 Voicemail: (503) 892-2897 Email: goldenbondrescue@yahoo.com www.goldenbondrescue.com |
Adoption Application / Foster Application
Thank you for taking the time to fill out this application. This is a combined Foster Home Application and Adoption Application. Please answer the questions in this application with your ultimate goal in mind, whether it is to FOSTER or ADOPT a Rescued Golden. If a question does not apply to you, please write N/A in the response area.
Please print this form and fill it in completely and clearly. Please include area codes with all phone numbers and please include your E-mail address, if at all possible. One of our representatives will be contacting you soon after we receive your application.
ADOPTION APPLICATION FEE: If you are applying to adopt one of our Goldens, please include a check for the $25.00 non-refundable application fee. Your application will not be processed until we receive the $25.00 fee.
Mail your completed Adoption Application/Foster Home Application to:
Adoption Application
Golden Bond Rescue of Oregon, Inc.
PO BOX 25391
Portland, OR 97298-0391
NOTE: Postage is generally $ .60 cents to mail this application.
General Questions about Rescue and Adoption please e-mail:
Goldenbondrescue@Yahoo.com
Date: ________________________
Are you interested in Adopting or Fostering? _______ Adopting _______ Fostering
About you and your family
| Your name: | Age: |
| Spouse's name: | Age: |
| Your address: |
| City/State/Zip: |
| Home Phone: | Work Phone: |
| Cell Phone: | Fax Number: |
| E-mail Address: |
| Your occupation: |
| Spouse's occupation: |
Please describe any animals you currently have:
Animal Type (dog, cat, bird, livestock, etc.)
Breed
Gender (M/F)
Age
Spayed/Neutered (specify for each pet listed)
About your household
Do you have children or grandchildren who live with you? YES NO (circle one)
Number of boys and ages
Number of girls and ages
Are there any other residents in the house?
Are there other animals or people who regularly visit your home (parent's dog, neighborhood children, relatives, etc.)? YES NO (circle one)
If YES, please describe:
Animal Type (dog, cat, etc.)
Breed
Gender (M/F)
Age
Spayed/Neutered
Are all the pets present in your household up to date on their vaccinations?
Do you have any immune-compromised pets?
Are there any special-needs pets in your household?
If adopting, are ALL household members in complete agreement to adopting, caring for, and training a Golden Retriever? YES NO
If fostering, are ALL household members in complete agreement to foster a homeless Golden Retriever? YES NO
Do any family members have allergies? If so, please specify what kind.
Part of agreeing to foster or adopt a Golden may include an in-home visit when all people and animals in the home are present. When would be a good time for us to come for a home visit?
About your home
What type of home do you live in?
[ ] Own Home [ ] Rent Home
[ ] Condo/Townhouse [ ] Apartment
[ ] Mobile Home [ ] Other
How long have you lived at your present address? Years _____ Months _____
If less than one year, give previous address:
How many stairs are in the home?
__________ From Street to Front Door
__________ From Main Floor to Basement
__________ From Main Floor to Second Floor
__________ From Main Floor to Yard
__________ Other
If you rent, do you have the permission of your landlord to keep a dog? YES NO
If yes, please include a copy of written permission. This must be included with this application or your application will be denied.
Your landlord's name and phone number:
May we have permission to contact your landlord? YES NO
Do you have a doggie door? YES NO
Is your yard fenced? YES NO
Please describe the fencing:
Height: _____ feet. Material: Block Wood Chain Link Other
Do you lock your gates? YES NO
Does your fencing completely enclose a yard? YES NO
Describe your yard:
Approximate size: ______ feet by ______feet
Grass? YES NO
Gravel? YES NO
Trees? YES NO
Bark Dust? YES NO
Dog door access? YES NO
Separate kennel run? YES: Approximate size: ______feet by ______feet NO
Do you have a spa? YES NO
If YES, is it kept covered when not in use? YES NO
Do you have a swimming pool or pond? YES NO
Is it fenced? YES NO
If YES, describe type of fencing:
Are you aware that most Golden Retrievers enjoy swimming and if you have an unfenced pool or pond, the Golden will most likely swim in it? YES NO
How do you plan to train the Golden to get out of the pool or pond?
Your experience with pets
I consider myself (Please circle number):
If you do not currently have a pet, have you owned a dog before? YES NO
What happened to your previous dog(s)?
Have you ever adopted a Rescue dog before? YES NO
If YES, from what Rescue organization?
Have you ever had to relinquish a dog? YES NO
If YES, what were the circumstances?
Have you ever bred a dog? YES NO
Are you familiar with the Golden Retriever breed? YES NO
Have you previously owned a Golden Retriever? YES NO
Please give the year when you acquired and, if now gone, lost your last Golden:
__________ Year Acquired (Example: 1992)
__________ Year Lost (Example: 2002)
If you have a Golden presently, why do you want to foster or adopt another Golden?
If you have current pets, or have owned a pet before, may we contact your preferred veterinarian? YES NO
Veterinarian's name and phone number:
Please provide at least one other reference other than a family member:
Name:
Phone:
The perfect Golden for you
Please briefly state why you would like to add a Golden to your family:
What gender dog do you prefer to foster or adopt? Male Female Either
What is your age preference? ______________ Why?
What do you expect in a Golden Retriever companion? (e.g., protection, friendship, child's friend, appearance, hunting, obedience, agility, other)
Please rate the following canine traits in the order of most displeasing to least displeasing (1 = MOST displeasing to 7 = LEAST displeasing. Put a "7" for each trait that does not bother you.):
_____Barking
_____Chewing
_____Digging
_____Drooling
_____Jumping
_____Odor
_____Shedding
Are you aware that Golden Retrievers are 'people' dogs and will want to live inside with their human family? YES NO
Activity Indoors: Some dogs are lively and curious in the house, they like to play with you and follow you around. Some dogs lie down most of the time. Do you think that an active dog will annoy you? YES NO
Will it annoy you if the Golden gets up on your sofa or your bed? YES NO
If YES, how would you train the dog not to get on the furniture?
What type of personality/activity level are you comfortable with in a dog?
Would you be willing to foster or adopt a dog with health problems? YES NO MAYBE
Would you be willing to foster or adopt more than one dog at a time (littermates or dogs that cannot be separated)? YES NO MAYBE
Would you be willing to foster or adopt a senior dog (10+ years old) or special needs dog? YES NO MAYBE
Would you be willing to foster or adopt a very young Golden or a puppy? YES NO MAYBE
Would you accept a mixed breed that is part Golden? YES NO MAYBE
Caring for your golden
Who will be the primary caretaker of the dog?
How long are you gone each day?
Where will the Golden sleep at night?
Where will the Golden be housed during the day when you are home?
Where will the Golden stay while you are gone during the day?
How often do you travel?
When you travel, who will care for the Golden?
[ ] Kennel [ ] Friend's house [ ] Trainer
[ ] Groomer [ ] Vet [ ] Other (describe):
What type of vehicle(s) do you own?
How will you transport the dog in a vehicle?
How will you exercise the Golden Retriever?
Daily walks _____ Fetching _____ Jogging _____ Hiking _____
Swimming _____ Run Free in Backyard/Dog Park _____
Other (describe):
Will you keep a collar on your dog? YES NO
If YES, describe (buckle-type, quick-release type, chain-type, etc.):
If NO, why not?
ID Tag? YES NO Microchip? YES NO License Tag? YES NO
How much grooming are you willing to do?
None ____ Daily _____ Weekly _____ Monthly _____
How much adult supervision of dog and child will be provided? (Check one)
Total _____ Some _____ Minimal _____ None _____
With neighborhood children? (Check one)
Total _____ Some _____ Minimal _____ None _____
How much responsibility will your child or children be given in the care and management of the dog?
T = Total S = Some M = Minimal N = None
(circle applicable letter for each)Housebreaking: Socialization: Feeding: Household & Social Behavior Grooming: Obedience Training:
Are you aware that a Golden Retriever is considered a large breed and therefore, has higher maintenance costs (food, vet, equipment, grooming bills) than a smaller breed of dog? YES NO
Are you willing to take your Golden to a veterinarian for an annual physical and vaccinations? YES NO
Are you willing to have your Golden tested annually for heartworm if advised by a veterinarian in your geographic area? YES NO
Training your golden
If adopting, will you agree to take the dog to obedience classes if recommended by the Adoption Director? YES NO
Have you ever completed an obedience class with a previously owned dog or current dog? YES NO
If yes, what were the training techniques you learned?
Do you understand that Goldens are a large breed of dog and that some of the Rescues will come with minimal training and may need a large amount of patience? YES NO
Are you agreeable to crate training? YES NO
If NO, why not?
Some of the rescued Goldens have been backyard dogs and are therefore not housetrained. Have you ever housetrained a dog before? YES NO
Are you comfortable with having to housetrain a Golden? YES NO
Even some housetrained Goldens will have accidents in the house for a while after they come into an unfamiliar home. What steps will you take to help your Golden avoid such accidents?
If your Golden is not already housetrained, what housetraining methods do you plan to use with your Golden?
Some Goldens have been left in backyards by neglectful or untrained owners and have developed anxiety to thunderstorms or loud noises in general. Have you ever dealt with a dog with "noise anxiety?" YES NO
Are you willing to read some information on behavior modification and work with the rescued Golden to overcome such anxieties? YES NO
Due to their "history," some Rescued Goldens have developed separation anxiety.
Have you ever dealt with such a dog? YES NO
If NO, would you be willing to read some information on behavior modification and work with the dog to overcome this problem? YES NO
Some rescued Goldens come from physically abusive homes and are extremely timid and have a condition called "submissive urination." Usually this condition lasts only a few days. Once the Golden knows he is in a home where he will not be beaten or abused and his self-esteem and confidence return, this problem usually takes care of itself. However, if it does not, are you willing to read some information on behavior modification to help the Golden overcome this condition? YES NO
Other items
Would you like to become involved in Golden Retriever Rescue? YES NO
How did you hear about Golden Bond Rescue of Oregon, Inc.?
NOTE: Are you aware that the Adoption Fee for this dog(s) will be the least of your expenses during his/her lifetime? Expenses include good nutrition, annual vet exams and shots, and grooming. As with most pedigree breeds, Goldens may be prone to skin allergies, some degree of hip dysplasia and cancers that can be expensive to treat. YES NO
General agreement
I am at least 21 years of age. All of the information I have given is true and complete. I understand that Golden Bond Rescue of Oregon, Inc., has the right to refuse my application.
( ) I am applying to adopt and have enclosed the $25.00 non-refundable application fee with this application.
| Applicant's Signature | Date |
| Spouse's Signature | Date |
For people interested in FOSTERING:
APPROVED-TO-FOSTER HOMES MAY INDEED ADOPT THEIR FOSTER GOLDEN!!! Foster families must fill out the appropriate paperwork, including contracts, and pay the adoption fee. We appreciate the time it took to fill out this application. Thank you so much for offering to open your home to give a Golden a second chance. Our foster homes are the most important link in the Rescue chain. If your application is approved, you will be entered into our database for families interested in fostering Rescued Goldens. The Foster Home Coordinator will use the information you provided to assist us in placing a dog in a foster home. You will be contacted by the Foster Home Coordinator when a dog needs a foster home.
For people interested in ADOPTING:
Thank you for your interest in Golden Bond Rescue of Oregon, Inc. We appreciate the time it took to fill out this application. If your application is approved, you will be notified by either E-mail or a phone call. If you are approved, then after your approval notification, you will be called to schedule a home visit and then placed on our waiting list. If your application is approved, the Adoption Team will carefully match your lifestyle and needs with an available Golden ASAP, depending on the waiting list. If you get a Golden from another source, or change your mind about adopting from us for any reason, please notify us so we can remove you from our waiting list.
FOR RESCUE USE ONLY
_____ Received
_____ Sent FAQ Sent Crate Brochure Sent Breed Information
_____ Referred to F/T
_____ Rents - received written permission
_____ Approved ______ Notified
_____ Denied _____ Notified
Adapted with permission FROM Rescue A Golden of ArizonA (Revised by Golden Bond Rescue of Oregon, Inc., 2002)