Adoption Application
This application is for anyone who is interested in adopting a dog from Golden Gate Rescue Center.
Contact Information
First and Last Name *
Your answer
Email Address *
Your answer
Phone Number *
Your answer
Best time to call? *
Full Address (Must include city, state, and zip) *
Your answer
Family and Housing
How long have you been at the listed address? *
Your answer
What type of home do you live in? *
Please describe your household: *
Own, Rent, Other? *
If you rent, please provide the landlord's contact information.
By providing this information, you are giving Golden Gate Rescue Center permission to contact your landlord. Please advise them of this so they can expect a call from us.
Landlord's Name and Phone Number
Your answer
How many adults are in the home and their relationship to you? *
Your answer
How many children are in the home (ages)? *
Your answer
Does anyone living in the home have known allergies to dogs or cats? *
Is everyone in agreement on the decision to adopt? *
Do you have other pets in your home? *
If you have other pets in your home, please describe species, age, and breed.
Your answer
Are these pets up to date on vaccinations? *
Are these pets on heartworm preventative? *
Are these pets spayed or neutered? If not, why? *
Your answer
Have you ever surrendered a pet? If yes, why? *
Your answer
Have you ever had a pet euthanized? If yes, why? *
Your answer
How do you discipline your pets and why? *
Your answer
Veterinary Information
By providing this information, you are giving Golden Gate Rescue Center permission to contact your veterinary clinic to verify care provided to previous and/or current pets and to check spay/neuter history. Please advise them of this so they can expect a call from us.
Do you have a regular veterinarian? *
Veterinarians Full Name
Your answer
Veterinary Clinic Name
Your answer
Veterinary Clinic Address (Must include city, state, and zip)
Your answer
About the Dog You Wish to Adopt
What is the name of the dog you wish to adopt, If applicable?
Your answer
What is your idea of an ideal dog and why? *
Your answer
Desired age, size, breed? *
Your answer
Desired Gender: *
Willing to Adopt: *
Where will the dog spend the day? *
Your answer
Where will the dog spend the night? *
Your answer
Where will the dog stay while you are on vacation? *
Your answer
Is your yard fenced? *
When the dog goes outside, how will it be supervised? *
Your answer
Average number of hours dog will spend home alone: *
Who will have primary responsibility for daily care of dog? *
Your answer
Who will have primary financial responsibility? *
Your answer
Do you agree to provide regular healthcare by a licensed veterinarian? *
Do you agree to keep the dog as an indoor dog? *
Do you agree to contact Golden Gate Rescue if you can no longer keep this dog? *
Are you willing to allow a representative of GGRC visit your home by appointment? *
How did you hear about Golden Gate Rescue? *
Would you be interested in fostering for GGRC? *
Personal References:
Please provide 2 references who are familiar with you and your pets.
Reference #1 First and Last Name *
Your answer
Reference #1 Phone number and their relationship to you: *
Your answer
Reference #2 First and Last Name *
Your answer
Reference #2 Phone number and their relationship to you: *
Your answer
Any additional information you would like to provide us with?
Your answer
I certify that the statements made on this application are true and correct entirely. I understand that any false statements made by me may lead to the rejection of this application for adoption. *
By submitting this application, I agree to hold Golden Gate Rescue Center harmless from and against all loss, cost, liability, damage, expense, penalties, fines, and claims, whatsoever, in connection with the loss of life, personal injury, and/or property damage, arising from the adoption of this animal. *
For adoption purpose: This dog will reside in my home as a pet. I will provide it with quality food, plenty of fresh water, indoor shelter, affection, annual physical examinations under the supervision of a licensed veterinarian. If I can no longer keep this dog, I will contact and return this dog to GGRC. *
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