Contact Information Name of applicant:  * Name of co-applicant:  * Email address:  * Home phone: Cell phone: Address: City: State: Zip code: Applicant occupation and work schedule: Co-applicant occupation and work schedule:   Preliminary Information If we called tomorrow with the perfect foster Golden would you be ready? Please explain. How did you learn about GRRH?   New Family Information Please list all members of your household (excluding pets). Indicate names & ages. Please list all pets (dogs cats bird etc.) of your household (names ages breeds genders). Are all of your pets spayed and/or neutered? If no please indicate the status for each pet. Other than children living in the household will your Golden come into contact with any children under the age of 5 years (e.g. grandchildren neighbors etc.)? If so how often and what ages? Do any elderly or physically challenged family members live with you or visit frequently?   Home Environment What type of dwelling do you live in? Do you have a fenced yard? If yes what type and height of fence? Do you have a dog door?   Your History With Pets Will this be your first dog to foster? Will this be your first Golden Retriever to be guardian over? What other breed of dogs have you been the caregiver for? If a pet has died that has resided in your household within the last 15 years please explain when at what age and under what circumstances. Please include an explanation for each pet that has died. Have any of your dogs had heartworms?   Care of Your Golden Do all members of the family want to foster a Golden Retriever? Why do you want to foster? Why do you think you would be a good caregiver for a Golden? Would you consider a special needs dog such as one who requires medication for a permanent but controlled condition? What age golden fits with your lifestyle and expectations? Please explain. Are you aware that Golden Retrievers are very active? Are you aware that Goldens shed year-round? Are you aware that Goldens are large dogs and may jump-up on children and the elderly? Is there anyone in your home who may be adversely affected by dogs (e.g. due to allergies)? If so please explain. Who will care for train and exercise the dog? How will you provide exercise for your foster Golden? Is anyone home during the day? If so who and what age? How long will the Golden normally be left alone each day? Where will the Golden be kept during the day when no one is home?   Post-Application Process May we visit your home prior to application approval? Please indicate the best day of the week and time during the day that you and your family would be available for a home visit. May we contact your veterinarian? If so provide name and contact information of your vets' most recent addresses and phone numbers. Please list two references (other than your vet) their relationship to you and their contact inforomation   I/we attest that the information provided on this application is true and accurate to the best of my/our knowledge. I understand that any misrepresentations of fact may result in the removal of the foster dog from my home by GRRH.   I/We attest that the Terms and Conditions of Adoption as stated above have been read in full by me/us and I/we understand that these terms constitute a part of the adoption agreement between me/us and GRRH and will be enforced.   The volunteer assumes all risks relating to working with the GRRH dog(s). The volunteer hereby releases GRRH its officers directors participants volunteers and affiliates ("GRRH" Participants) from any and all claims actions liabilities damages and costs of any kind (claims and costs) arising out of transportation fostering or any other work or activity with any dog connected with GRRH or a dog owned by GRRH volunteer. If anyone in the volunteer's household makes a claim the volunteer will indemnify defend and hold GRRH and the GRRH participants harmless from such claims and costs. Volunteer hereby authorizes GRRH to contact the references or veterinarian contacts given in this application.   Name of applicant  * Date  * Name of co-applicant  * Date  * Do not enter anything in this field: