Applicant Name
Street Address
City State   Zip
Home Phone
Work Phone
Cell Phone (if applicable)
E-Mail

Employment

Your Employer
Position
Work Phone

Co-applicant's Employer
Position
Work Phone

A complete answer to the following questions will enable us to be more familiar with your request and requirements, and will help us find the Golden Retriever to match your needs and expectations:
Do you have any children? Yes No   If so, please give their ages:
Do they or other family members live with or visit you? Yes N/A No
Does anyone in your household have allergies? Yes No  
If so, please tell us what kind of allergies?
May we visit your home prior to application approval? Yes No
When is the best time for a home visit by MAGRR?
Please list any additional pets you have in your household:
  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
  Species Dog Cat Bird Rabbit Other Breed Name Age Sex (select one) Male/Neutered Female/Spayed Male Female
 

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?

 

How long have you lived at your current address?
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
If so, up to what size?  

Will the dog be allowed in the house? Yes No   Which parts?
How long daily will the dog be left alone (without humans)?
Where will the dog stay normally when you are away from the house?
 

Are you willing to bring your foster dog to scheduled adopt-a-thons? Yes No
Are you willing to take your foster dog to any vet appointments if scheduled at your convenience? Yes No

Are you familiar with the use of a dog crate to train the pet during your absence or at night? Yes No

Is your yard fenced? Yes No Describe your fence:
What is the approximate size of the dog's yard area?
Will the dog be walked daily? Yes No Will he/she be exercised in a fenced yard? Yes No
Will he/she be allowed to run free without supervision? Yes No

Have you ever owned a golden retriever? Yes No   Are you aware the goldens are a very active breed, and that they shed all year long? Yes No

Have you, or any member of your family/household been cited for leash law violations or cruelty to animals in the past? Yes No   If so, please explain:

Have you sold, given away, or surrendered a pet to a shelter? Yes No   If so, please explain:

Please tell us a little of your lifestyle and your family, including any special activities that your foster dog would get to participate in.

Tell us if you have any special requests or requirements in a foster dog:
 

How did you hear about MAGRR?

Are you a golfer? Yes No

Are you a runner? Yes No

Thank you for submitting your application.  You will receive a confirmation page after hitting the submit button.  We appreciate your willingness to help MAGRR, and our goldens in need.  We will begin reviewing your application shortly.