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Applying for Adoption
  1. Date Stamp
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    This is a date stamp for the application.
  2. This is the Foster-With-Intent-To-Adopt (FWITA)/Adoption Application Or Foster Only Application. Thank you for taking the time to fill out this application. We realize it is lengthy, but please fill out this form completely, as it will speed the process. Please include area codes with all phone numbers, and please include your e-mail address. A representative from our Home Evaluation Team will contact you as soon as possible after we receive your application. This is a combined application for families who desire to serve as foster-only homes, who want to be considered as a Foster-With-Intent-To-Adopt (FWITA), or who want to do a straight adopt from Arizona Golden Rescue. Please answer the questions in this application with your ultimate goal in mind, whether it is to foster or to adopt a Rescued Golden. If a question does not apply to you, please write N/A in the response area.
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  1. Contact Information

  2. First Name(*)
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  3. Last Name(*)
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  4. Spouse/Partners (if applicable) (Full name please)
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  5. Your Address(*)
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  6. City(*)
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  7. State
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  8. Zip Code(*)
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  9. Home Phone # (xxx-xxx-xxxx)
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  10. Work Phone # (xxx-xxx-xxxx)
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  11. Cell Phone # (xxx-xxx-xxxx)
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  12. Best number to contact(*)
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  13. E-mail address
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  14. 2 Major Cross Streets
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  15. Are you currently a member?(*)
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  16. If So Date Joined(mm/dd/yyyy)
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  17. When would be a good time for us to come for a home visit?
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  18. How did you find out about Arizona Golden Rescue(*)
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  19. If recommended by an AGR Member, please tell us who
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  1. Household Information

  2. What type of home do you live in?(*)
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  3. If other type describe
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  4. How long have you lived at your present address? Years and Months (*)
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  5. If less than one year, give previous address
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  6. Previous City
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  7. Previous State
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  8. Previous Zip Code
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  9. FOR RENTERS ONLY: Do you have permission of your landlord to keep a Golden Retriever? IF YES, YOU MUST PROVIDE A COPY OF WRITTEN PERMISSION AT TIME OF HOME EVALUATION
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  10. Are there stairs in your home?(*)
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  11. If yes, please describe.
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  12. What type flooring do you have in your home(check all appropriate)?(*)
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  13. If combination, please describe
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  14. Is your yard fenced(*)
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  15. Please Describe the fencing
  16. Height:
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  17. Fence Material
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  18. Does the fence completely enclose back yard?(*)
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  19. Are gates kept latched of locked?(*)
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  20. Please describe your yard (Please check all that apply)(*)
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  21. Do you have a spa?(*)
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  22. If YES, is it kept covered when not in use?
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  23. Do you have a swimming pool?(*)
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  24. If YES, Is it fenced?
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  25. If Yes, describe type of fencing
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  26. Are you aware that most Golden Retrievers enjoy swiming and if you have an unfenced pool, the Golden will most likely swim in it?
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  27. Will you allow the Golden to use the pool?
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  28. How do you plan to train the Golden to get out of the pool?
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  29. Do you have a doggie door? (This is not a prerequisite, but one is helpful if you are away from home more than 8 hours per day)(*)
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  30. If NO, would you be willing to install one, if it is recommended?
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  31. If NO, why not?
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  32. Are you employed outside the home?
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  33. How many hours are you away from home?
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  34. Is your spouse employed outside the home?
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  35. How many hours per day is he/she away from home?
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  36. Do you have children or grandchildren who live with you(*)
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  37. Ages of children
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  38. Do you have grandchildren who visit frequently?(*)
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  39. Ages of Grandchildren
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  40. Are all the pets present in your household up to date on their vaccinations?(*)
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  41. If NO, please explain why?
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  42. Do you have immune compromised pets or family members in your household?(*)
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  43. Are there any special-needs pets or family members in your household?(*)
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  44. Do any family members have allergies?(*)
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  45. If YES, please specify which kind
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  46. If you currently have other pets, please describe breed, age, and gender
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  47. Name and phone number of local veterinarian you have used:(*)
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  48. What type vehicle(s) do you own? (Please be specific e.g.Ford Escort, Dodge Caravan, Chevy Extended Cab Pickup, etc.) (*)
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  49. How will you transport the dog in a vehicle? (loose in vehicle, tied down in vehicle, behind in a crate, etc.) PLEASE NOTE : AGR WILL NOT ALLOW DOGS TO BE TRANSPORTED IN THE BACK OF A PICKUP TRUCK EVEN IF CONFINED IN A CRATE)
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  50. How often do you travel?(*)
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  51. When you travel, where will the Golden be?(*)
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  52. If other, please specify
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  1. Golden Preferences Please be as flexible as possible with your preferences

  2. What gender dog do you prefer to foster or adopt?(*)
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  3. What is your age preference? Please note: it is the policy of AGR not to plave a dog under 3 years of age with a family that has children under 3 years of age.(*)
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  4. Would you consider a Golden Mix?(*)
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  5. Would you consider a pair?(*)
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  6. Would you consider a dog with mild health problems easily treated with medication such as valley fever, hypothyroid, mild allergies, mild arthitis?(*)
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  7. Would you consider a dog with major health problems, such as epileptic, diabetic, dog with severe allergies or cancer?(*)
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  8. Would you consider a senior dog (over 9 years of age?)(*)
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  9. Will the dog live inside the home with you?(*)
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  10. Activity Indoors: Some Goldens are lively and curious in the house; they like to play with you and follow you around. Some Goldens lie down most of the thime. Do you think that an active dog will annoy you?
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  11. Will it annoy you if the Golden gets up on your sofa or your bed?
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  12. If YES, how would you train the dog not to get on the furniture?
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  1. YOUR EXPERIENCE WITH PETS

  2. I consider myself:
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  3. Please describe other pets you have had, how long you had them, and whether they were with you their entire lives.
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  4. If you have never had a Golden, why do you want one now?
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  5. Have you rescued a dog before?
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  6. If Yes, from what Rescue orgnaization
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  7. If NO, why do you want to foster/adopt a dog?
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  9. Have you ever had to relinquish a dog?
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  10. If YES, what were the circumstances?
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  11. How will you exercise the Golden? (Please be aware that younger dogs require more exercise)
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  12. If other, please describe:
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  13. Are you aware that a Golden Retriever is considered a large breed and has a higher maintenance costs (food, vet, equipment, grooming bills) than a smaller breed of dog?
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  14. Do you think you an afford the cost of caring for a Golden?
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  15. Are you willing to take your Golden to a veterinarian for an annual physical and vaccinations?
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  16. Are you willing to have your Golden tested annually for valley fever?
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  17. Are you willing to have your Golden tested annually for heartworm?
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  1. Training and Behavior

  2. If adopting, will you agree to take the dog to obedience classes if recommended by Arizona Golden Rescue?(*)
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  3. Have you ever completed an obedience class with a previously owned dog or current dog?(*)
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  4. If yes, what were the training techniques you learned?
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  5. 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?(*)
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  6. Are you agreeable to crate training?(*)
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  7. If NO, why not?
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  8. A rescued Golden may have one or more of the following behaviors. Please tell us how you would handle such behavior:
  9. Barking(*)
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  10. Chewing(*)
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  11. Digging(*)
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  12. Drooling(*)
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  13. Jumping up on people(*)
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  14. Shedding(*)
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  15. Some Goldens have been backyard dogs and are therefore not housetrained. Have you ever housetrained a dog?(*)
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  16. Are you comfortable with having to housetrain a Golden?(*)
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  17. If your Golden is not already housetrained, what housetraining methods do you plan to use with your Golden?(*)
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  18. Even some housetrained Goldens will have accidents in the house for awhile after they come into an unfamiliar home. What steps will you take to help your Golden avoid such accidents?(*)
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  19. Some Goldens have been left in backyards by neglectful or untrained owners and may have developed anxiety to thunderstorms or loud noises in general. Have you ever dealt with a dog with noise aniexty?(*)
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  20. If NO, are you willing to read some information on behavior modification and work with the rescued Golden to overcome such anxieties?
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  21. Due to their "history", some Rescued Goldens have developed separation anxiety. Have you ever dealt with such a dog?(*)
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  22. If NO, would you be willing to read some information on behavior and work with the dog to overcome this problem?(*)
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  23. Some rescued Goldens come from physically abusive homes and are extremely timid and have a conditioncalled "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 usaually 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?(*)
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  24. Are yo agreeable to crate training if such is recommended?(*)
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  25. If NO, why not?
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  1. General Agreement

  2. I/we am/are at least 21 years of age. All of the information I/we have given is true and complete. I/we understand that Arizona Golden Rescue has the right to refuse my/our appplication.(*)
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  3. All household members are in complete agreement to foster and/or adopt a rescue Golden Retriever.(*)
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  4. I/we understand as a foster of FWITA, I/we are responsible for providing a good quality dog food, for absorbing the costs of any toys or treat should we choose to purchase any, and covering any transportation costs to and from the vets when necessary. Approved vet care, prescription dog food and medications will be paid for by AGR as long as the fogs is in foster care (i.e. until adoption is finalized.)(*)
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  5. I/we understand that Arizona Golden Rescue remains co-owner for the life of any Rescued Golden that comes through AGR program and that AGR has the right to reclaim any foster or adopted Golden if the Exeecutive Board of Directors feels that doing so is in the dog's best interest.(*)
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  6. I/we understand that I/we must pay the adoption fee by check or credit card at the time the rescued dog is delivered to my/our home. If, after a 21-day settling-in period, I/we choose not to adopt this dog, I/we understand that the adoption fee will either be refunded or will be applied towards the adoption of another AGR rescue.
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  7. Applications Name (By typing/entering my name, I intend to affix my electronic signature)
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  8. Date
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  9. Spouses signature (By typing/entering my name, I intend to affix my electronic signature)
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  10. Date
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  11. Rev 8-10-11 EL
  12. To all who fill out this application: Due to insurance requirements, you must be a member of Arizona Golden Rescue before we can bring a foster dog to your home. To become a member now, please download and fill out the Membership Application under Info and forms and send it in with your payment as soon as possible. If you wish you can call us and we will mail you the form. Thank you.
  13. What does Foster With Intent to Adopt (FWITA) mean? If your intent is to adopt, then you will become a FWITA. A dog based on your criteria will be placed in your home and an adoption fee will be collected. During the foster phase, AGR will take care of all vetting and you will get to know your dog. After 2-3 weeks the adoption is finalized. The choice to permanently adopt the dog is your decision. If you decide the dog you have during the foster phase would be better placed with a different family, we abide by your wishes.
  14. For people interested in FOSTERING: 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 Placement Department will use the information you provided to assist us in placing a dog in your home. Someone on the Placement Team will contact you when a dog needs a foster home. 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. Thank you so much for offering to open your home to give a Golden a second chance. For people interested in ADOPTING: Thank you for your interest in adopting a dog from Arizona Golden Rescue. 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 placed on our waiting list. If your application is approved, the Placement Department 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
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