First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

County*

Email*

Home Phone*

Cell Phone*

Alt Email

What is your middle initial? *

Co-Applicant Name & Middle Initial: (If there is another adult living in your home you must include them as your co-applicant).*

Applicant Age*

Co-Applicant Age

Please tell us the name of your employer, your position within the company and provide a contact number. *

Name of co-applicant's employer, position within the company and contact number.*

Relationship to Applicant

Have you or anyone in your household ever been warned, cited, arrested or convicted of animal or domestic abuse? If yes, please explain.*

What is the best time to contact you?*

In what type of home do you live?*
Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing

Do you own or rent your home?
Choose one: Rent Own

If you rent, please enter your landlord's name and phone number.*

If you rent, have you received the approval of your landlord to have a large dog?*
Choose one: Yes No

How many people live in your home? *

Are their children in your home? If so, how many and what are their ages?*

Do you have grandchildren? If so, what are their ages?*

Are you willing to supervise any children around your foster dog at all times?*

Is anyone in your household allergic to animals or have asthma?

Please list all all pets you have owned in the past 10 years: (include type/breed; age; gender; how acquired; spayed/neutered; behavior with other dogs; where the pet is now.)*

Please provide contact info (NAME AND PHONE #) for your current veterinarian. If you don't currently have pets or are new to the area, please provide info for your previous vet. If you do not currently have a veterinarian, you will need to provide a 3rd personal reference, NOT related to you. *

Have all of your pets (past and present) been spayed/neutered? If not, please tell us why.*

Are your pets current on vaccines? If not, please explain.*

Is your yard fenced? If yes, tell us what type (wood, vinyl, iron, etc.) and how tall it is.*
Choose one: Yes No

What type of fence*
Choose one: Privacy Chain Link Invisible

Is your yard fenced? If yes, what type (wood, iron, vinyl) and how tall is it? *

Have you fostered before? For which organization? What kind of dog?*

Do you own a crate? *
Choose one: Yes No

What is your experience with crate training?*

Have you ever owned a Golden Retriever?*

Have you ever obedience trained a dog?*

Have you ever house trained a dog?*

Where will the animal be kept when you are not home?*

Where will the dog sleep?*

We require that the dog be kept inside when an adult is not at home. By signing here, you are agreeing to comply with this requirement:*

Please tell us how you will introduce your foster dog to your current pets.*

Please describe your experience as a dog owner, and provide an honest assessment of your abilities to deal with any problem behaviors a foster dog might exhibit (i.e.: barking, digging, growling, chewing, food possessiveness, jumping, lack of house training etc):*

Please list two references who are NOT family members. State name, contact info and relationship to you.*

What type(s) of foster dogs are you willing to have in your home? Adults Puppies Senior Males only Females only Either Heartworm Positive Special Needs (with medical conditions, requiring medication)*

How many dogs are you willing to foster at one time?*

How did you hear about Grand Strand Golden Retriever Rescue?*

Our adoption process requires a home visit be conducted. Are you willing to allow a GSGRR volunteer to visit your home for this purpose?*
Choose one: Yes No

GSGRR makes no warranties or representations regarding the dog(s)’s health or temperament. It is agreed and understood by the ADOPTER/FOSTER FAMILY that while every effort is made to provide an accurate history and assessment of a dog(s), GSGRR does not warrant any dog(s) regarding medical status, behavior, or disposition. It is further agreed that environmental changes may effect and change the temperament of the above named dog(s) and that GSGRR has no liability or responsibility of any nature regarding defects with the dog(s), or injuries or damage to any person or property which may be caused by the dog(s). ADOPTER/FOSTER FAMILY agrees to indemnify and hold harmless GSGRR, its members and representatives against any and all claims, known or unknown, now or hereafter arising in connection with this dog(s).

I certify that the information entered on this applicant is true. Enter your name and date.*