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Adoption Application


There is a $30 Non-refundable Application Fee. You may pay by check or PayPal/Credit Card.

If paying by check, please enter your Check Number and Date of Check in the Application Fee box listed below. If paying with PayPal /Credit Card, please enter Online Payment in the Application Fee box.

Check mailing instructions and PayPal/Credit Card options will be presented after you submit your form.

* required information

*Application Fee:

A value is required.

Application does not guarantee adoption of a dog from TGRR. Your application will be reviewed once the fee has been received and you should be contacted within 2 weeks after the check clears.

Applicant 1

*First Name: A value is required.
*Last Name:
A value is required.
*Email: A value is required.Invalid format.
*Home Phone: A value is required.
Mobile Phone:
Work Phone:

Applicant 2

First Name:
Last Name:
Mobile Phone:
Work Phone:

Home Address

*Address 1 A value is required.
Address 2
*City A value is required.
*State Please select an item.
*Zip Code:
A value is required.

Dog Preferences

*Gender: Male   Female    No Preference Please make a selection.
*What age range Golden do you prefer? A value is required.
*Would you consider adopting a senior or special needs Golden? Yes   No Please make a selection.
Additional Preferences:
Reasons for wanting a Golden Retriever:

Family Structure and Lifestyle

*Do you own or rent? Rent   Own Please make a selection.
*Do you live in a house, townhouse, or apartment? House   Townhouse   Apartment Please make a selection.
If you rent, do you have your landlord's permission to own a dog? Yes   No

Fence Information

*Do you have a fence? Yes   No Please make a selection.
If Yes, is the fence attached to your home? Yes   No
What type of fence is it?
What is the height of the fence?
Is it secure? Yes   No

Family Life

*Where will the dog stay during the day? A value is required.
*Where will the dog sleep? A value is required.
*Where will the dog exercise? A value is required.
*Do you have children at home? Yes   No Please make a selection.
Ages of children
Are they comfortable with large dogs?
Who will be responsible for taking care of this dog?
*How many hours would your dog be alone on an average day? A value is required.
Does anyone in your family have a problem with allergies or dog hair?

Other Pet Experiences

*Have you owned a pet before? Yes   No Please make a selection.
What kind?
What happened to it/them?
Was your previous dog an inside pet or an outside pet? Inside   Outside
*What other pets do have you have now? A value is required.
If your pets are dogs, what is the gender?
Have they ever played with or been exposed to other dogs (socialized)? Yes   No
What were their reactions?
*How do you or would you discipline your dog? A value is required.
*Have you ever obedience trained a dog? Yes   No Please make a selection.
Would you let the dog off the leash outside of a fenced area? Yes   No
*Where will dog stay when you go on vacation? A value is required.
*Who is your regular vet? A value is required.
Please provide your vet's phone number
*Are you ready and willing to take responsibility for a dog, including annual vet checks, vaccinations, boarding, medical care, food? Yes   No Please make a selection.
Have you sold, given away, or surrendered a pet to a shelter, rescue group, or the Humane Society? Yes   No
If Yes, please explain:
*Have you applied to any other Golden Retriever Rescue groups? Yes   No Please make a selection.
If Yes, please specify the group(s) so that we do not duplicate their efforts:

Please add any additional information or comments below:

Next Steps:

1. If paying your $30 application fee by check, please mail it to the address listed below, and write Adoption Application in the note section of your check.

6828 Deer Haven Rd
Belews Creek, NC 27009

2. In order to avoid a delay in processing your application, please immediately contact your Veterinarian, and authorize the release of information to Triad Golden Retriever Rescue. A TGRR volunteer will contact your Veterinarian asking if you have kept pets up-to-date on vaccinations and provided heartworm and flea/tick prevention to your dog(s).

3. Once your application fee is received and veterinarian reference is obtained, a TGRR volunteer will contact you for a Telephone Interview.

4. A Home Visit will be scheduled for applicants in the Piedmont Triad Area. For applicants who live outside of the Triad, supplementary materials will be requested in lieu of a Home Visit.

Once the screening process has been completed, you will be notified via email as to whether your application has been approved.

Application to TGRR does not guarantee adoption of a dog from our organization. The number of applications received far outnumbers the number of dogs we receive.

If you have additional questions, please check the Frequently Asked Questions section of the TGRR website, or email your question to

For your records, a copy of this application will be sent to the email address provided for Applicant1