Bearabella Golden Retriever Application

First Name:

Last Name;

Street Address:

City:

State:

Zip Code:

Phone Number:

Email Address:

Occupation:

What days and hours do you work?

Spouse or significant other's Name:

Spouse or significant other's occupation:

What is your approximate age?

Please describe your activity level?

Does anyone in the family have any disabilities? If so, please explain:

Does anyone in the family have allergies? If so who and to what?

Do you have children?

If yes how many children do you have and how old are they?

Is everyone in the family ready for a dog?

Do you have other pets?

What gender are they?

What are the ages are your other pets?

Please provide your veterinarian's name, address, and phone number:

What type of housing do you live in? House, apartment, condo, duplex?

Do you own or rent?

If you rent, does your landlord allow large dogs in the residence?

Please provide your landlord's name, address and phone number if you rent:

Does your home have a fenced in yard?

How big is your yard and what type of fencing does it have?

Do you own a pool?

If you have a pool is it fenced off separately from the rest of the yard?

Why do you want a Golden Retriever?

Do you plan to show, do obedience, agility or therapy work with this dog?

Are you looking for a puppy or an adult dog?

Do you prefer a male or a female?

If your first choice is not available, would you be willing to take a puppy of the opposite sex, a different color, or one from a different litter?

Have you ever owned a Golden Retriever before?

Do you know the pros and cons of Golden Retrievers?

Who will be home with this dog during the day?

Who will be home with this dog during the night?

If you are gone for long periods of time during the day, do you have someone that can take care of the dog? If so please explain:

Who will train this dog?

Are you willing to crate train a puppy?

Are you willing to have this dog professionally groomed once a month?

Are you willing to feed this dog the food and supplements the breeder recommends?

Do you agree to keep this dog on a monthly heartworm preventative

Do you agree to give this dog a separate flea and tick preventative only when necessary for the optimum health of your dog?

Do you agree NOT to use any combination drugs for fleas, ticks, and heartworms that may cause seizures, other neurological disorders, and even death?

Do you agree to provide this dog with any and all medical care it may need?

Do you agree to provide this dog with fresh food and water every day?

Do you agree to house this dog in your primary residence in a temperature controlled environment?

Do you agree NOT to house this dog in the garage, basement, or outside in a kennel?

Do you agree to never leave this dog outside in severe weather of any kind?

Do you agree to never chain or tie this dog to a stationary object?

Do you agree not to let this dog run loose in an unsecured area?

Are you aware of the dangers of dog parks? Do you plan on taking this dog to one?

Are you willing to put a life vest on your dog when it first learns to swim?

Do you agree to never let this dog ride in the back of an open vehicle?

Do you agree to crate or harness this dog whenever it is transported in your vehicle to keep it safe?

Do you agree never to use electronic collars on this dog?

Do you agree to only use positive reinforcement training with this dog?

Do you agree to wait to spay or neuter this dog until after it is 24 months old for it's optimum health?

In the event that you can no longer keep this dog for whatever reason do you agree to return it to Ms Lamont?

Are you willing to stay in touch with Ms Lamont and give her updates on how your dog is doing?

Please provide three references outside of your immediate family with their names and phone numbers:

Please let us know how you found us:

Please provide us with any additional information that you would like us to know that will help us select the perfect dog for you:

Thank you for taking the time to fill out an application! Bearabella Golden Retrievers prides itself in placing its puppies and adults in loving forever homes. By signing this application you confirm that you have read and filled it out in its entirety and more importantly, honestly. Furthermore, you understand that applying does NOT ensure approval, and that false answers or failure to fill out the form completely will result in the forfeiture of this application. Thank you for your interest in a Bearabella Golden Retriever!

Helena