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Online Adoption Application ****Please note that if you have entered the site through MAGRR.com instead of MAGRR.ORG, this link will not work.****
Contact Information
Last Name First Name: Co-Applicant Name Street Address City State Zip Home Phone Cell Phone Cell Phone E-Mail
Employment
Your Employer Position Work Phone
Co-applicant's Employer Position Work Phone Living Arrangements
Do you live on a busy street? Yes No
Describe your area:
Is your yard fenced? Yes No Describe your fence: Do you own or rent? If rent, please provide landlord's name and phone number: Do you have the permission of your landlord to have the dog? N/A Yes No As part of the application process, , a member of our adoption committee will visit you in your home. When is the best time for a home visit by MAGRR?
Do you have a valid drivers license and a vehicle suitable for transporting a Golden Retriever?
Do you have a swimming pool? N/A Yes No
Do you cover your pool? N/A Yes No
If you cover your pool, please describe the cover?
About the Family
Do you have any children? N/A Yes No Please give ages of all members of the household: Do they or other family members live with or visit you? N/A Yes No Please list any additional pets you have in your household: Species Dog Cat No Current Pet Bird Rabbit Other Breed Name Age Sex (select one) Male/Neutered Female/Spayed Male Female Species Dog Cat Bird Rabbit Other Breed Name Age Sex (select one) Male/Neutered Female/Spayed Male Female Species Dog Cat Bird Rabbit Other Breed Name Age Sex (select one) Male/Neutered Female/Spayed Male Female Species Dog Cat Bird Rabbit Other Breed Name Age Sex (select one) Male/Neutered Female/Spayed Male Female Species Dog Cat Bird Rabbit Other Breed Name Age Sex (select one) Male/Neutered Female/Spayed Male Female Species Dog Cat Bird Rabbit Other Breed Name Age Sex (select one) Male/Neutered Female/Spayed Male Female
Please tell us about ALL pets you have had during the past 5 years... Where are they now?
Does anyone in your household have allergies? Yes No If so, please tell us what kind of allergies?
Do all members of your household want to share their lives with a rescued golden? It's a Golden's Life
Who will be the primary caregiver for the dog?
Is the primary caregiver physically limited in his/her ability to properly care for and exercise a golden retriever? Yes No If you have physical limitations, please share that info with us so that we are more fully able to find an appropriate match for you.
Why do you want to adopt a rescue golden?
Tell us a bit about your experience with Golden Retrievers:
For which of the following reasons would you give up your dog? (select all that apply) moving not housebroken divorce gets too big shedding not getting along with other pets allergies behavior problems barking increase in work schedule aggressive medical problems new baby not getting along with children getting out of fence none children have lost interest other (list please)
What will you do if you are faced with an unexpected vet bill of $1,000 or more for a treatment required to save your dog's life? (select all that apply) credit card work out payment plan with vet take out a loan I would not do the treatment turn in to shelter give dog back to MAGRR ask MAGRR for financial help put the dog to sleep money is not a problem other (tell us your plan in the space below)
What amount of time do you think is reasonable for a dog to adjust to your family and environment?
How did you hear about MAGRR?
How long daily will the dog be left alone (without humans)? Where will the dog stay when you are away from the house?
Will the dog be allowed in the house? Yes No Which parts? Where will he/she sleep at night? Where will he/she spend the day?
What will you do with your golden is you go on vacation?
What will you do with your golden if you are relocated?
What do you think about tying a dog up outside?
Are you familiar with the use of a dog crate to train the pet during your absence or at night? Yes No
Are you willing to crate train if necessary? Yes No
Will the dog have formal obedience training? Yes No If Needed
If yes, please provide the name and number of the trainer
Are you aware that goldens love to be with their humans, and are you willing to devote as much time as possible to the newest member of your family?
Are you aware that the average cost per year for care and maintenance of a golden is at least $1,000.00?
Who will groom your rescued golden?
Are you aware that goldens need their ears cleaned and nails trimmed on a regular basis?
Are you aware that goldens shed all year long and require frequent brushing?
Please provide the full name, address, and phone number of your current veterinarian (PLEASE notify your vet's office that a representative for MAGRR will be calling and that you want them to release information to us): Name Phone Street Address City State Zip Code Where do you purchase heartworm preventative medication if not from your veterinarian?
I authorize MAGRR to contact my veterinarian
Are you familiar with your local licensing and leash ordinances?
Have you sold, given away, or surrendered a pet to a shelter? Yes No
If so, please explain:
Have you, or any member of your family/household been cited for leash law violations or cruelty to animals in the past? Yes No
We are interested in...
What sex are you interested in? Either Male Female What activity level would best suit your family? Low Moderate High
Will you consider a:
Special Needs Golden Senior Golden (8 or older) Mixed Breed Golden
Have you applied to any other rescue groups? Yes No
If so, which ones?
Feel free to make any additional comments:
If you golf, would you be interested in being a part of our annual golf tournament? Yes Out of Memphis Area No
If you are a runner or jogger, would you be interested in participating in our annual 9K9 run/walk? Yes Out of Memphis Area No
Do you understand that...
...you are making a commitment to love and care for this golden as long as he/she lives?
...the adoption fee for a MAGRR dog is $250.00?
...we will do our best to find a Golden that matches your preferences, but that our first priority is matching the right personality with the right home?
...if you do adopt a MAGRR Golden, you are to return the golden to MAGRR if you are unable to keep or care for him/her for any reason?
...you should NEVER take this Golden to a shelter, pound, or humane society, and that you should never give this Golden to someone else?
Thank you for submitting your application. You will receive a confirmation email after hitting the submit button. We appreciate your willingness to help MAGRR, and our goldens in need. We will begin reviewing your application shortly.
MAGRR Coordinator Comments:
Cody