Goldcker Puppy Application

PUPPY APPLICATION
BEFORE proceeding, please ensure you have read
Golden Retriever Information and Information about our breeding practice on our website.

Please note that this is NOT an agreement for us to place a puppy with you.

In addition to the full completion of this application, expect more questions to follow during a family meeting. There are no right or wrong answers as we rely on your honesty to help us provide further education and support. We use this form to assist us in matching a Golden Retriever to your lifestyle, situation and your expectations, all of which will give you and your Golden Retriever the best chance at success.
APPLICANT:
Full Name:*
Age:*
Spouse/Partner Name:*
Age:*
Occupation(s):*
Children:*
Age(s):*
If no children, are you planning on having children in the near future? If so, when?*
Any other household members?*
Age(s):*
Applicant Email:*
Spouse/Partner Email:
Applicant Cellphone:*
Spouse/Partner Cellphone:
Home Phone:
ADDRESS:
Home Address*

Street Address

Street Address Line 2

CityState

Zip Code

Have you ever had to euthanize a dog? If so, why?
Have you ever travelled with a dog loose in the bed of a pick-up truck or other vehicle?*
Have you ever exercised your dog by letting it run behind a vehicle?*
Under what conditions would you let your dog roam free off leash?*
Have you experienced any negative behavioural issues with past dogs you've owned and how did you address these?*
Have you any experience In training a dog? Please list types of classes, methods and results if applicable.*
Have you done any research on dog training, grooming, and other pet related services in your area with regards to getting a new dog? Please elaborate.*
Comments / Additional Info:

Veterinarian Information

Please fill out the information below if you have a current Veterinarian.
Please provide the name(s) of your Veterinarian and Clinic/Contact Information.
How long have you enlisted their services?
Is your Veterinarian a holistic or a conventional practitioner?
Have you ever questioned, or been uncomfortable with the advice you've received or heard from your Veterinarian?
Are you happy with your Veterinarian?
Would you be willing to change to another Vet to ensure your dogs' best quality of health?
Comments / Additional Info:
Vaccinations
Please check all that apply

I ensure my dog's vaccinations are always up to date.I follow the vaccination protocol my Veterinarian recommends.I prefer to administer minimal vaccinations.I am comfortable with natural alternatives to traditional vaccine protocol most Vets currently follow.I do not believe in vaccinations or prefer to use alternatives (nosodes, titer testing).
Have you done any research on limited vaccines, no vaccines or alternatives?*
Comments / Additional Info:

Feeding
Please Check all that apply*

I plan to feed what my Veterinarian recommendsI plan to feed a dry or canned food dietI plan to feed a RAW home prepared diet
Have you done any research on the benefits of feeding a natural, unprocessed RAW diet?*
What else do you plan to feed your dog (treats, chew items, etc...)?*
Comments / Additional Info:
Describe your family situation*

MarriedDivorcedSingle, but looking to find a partnerLooking to expand or start a familyPlans to Move
What is your work, occupation, and career plans?
What activities do you (and your family), like to do?
Which member of the household will have the primary responsibility for taking care of the dog?

Please answer if you have Children or Grandchildren, or children who visit your home.
What is their history with the dogs?
Have any of your children ever shown any nervous, shyness or aggressive behaviour towards any animal? If so, please explain:
How would you respond if your dog growled at a child?
Home Enviroment
Do you own your home or rent? How long have you lived at this residence?*
If you rent, do you have your landlord's permission to have a dog? If yes, please provide landlord's name and phone number:
Select your home setting ( choose one):
Describe your home location ( choose one):*
Do you own a swimming pool? If so, is it fenced?
If you have no fence or dog run, what are your plans for controlling your dog outside of your house?*
What kind of floor surfaces will the dog be on in the house?
Does anyone in your house have allergies? If yes, please describe:*
Does anyone in your household smoke? Do you allow visitors or guests to smoke in your home?*
Comments / Additional Info:

Your Dog's Education
What describes your thoughts (please select what best applies):*

I have an interest in learning more and continuing my dog's education.I have some questionsI am satisfied with what I know.I am intent on finding out all I can about educating my dog.
Briefly describe your experience in training a dog. Include all methods and results. If you have not had any experience, how do you plan on learning?
Your Dog's Health
What are your thoughts on spaying or neutering? Please explain:*
Are you willing to, as part of general health care and monitoring of your dog's health, to obtain the minimum 4 'Core' health clearances required by all responsible Golden Retriever Breeders/Clubs (Hips, Elbow, Heart and Eye) on your puppy, and continue with Annual Eye exams by a Specialist?*
Are you considering purchasing pet insurance for your Golden Retriever?*
Comments / Additional Info:
Breeding your Golden Retriever
Do you plan on spaying/neutering your Golden Retriever? At what age?*
Have you ever bred a dog in the past? If yes, please describe.*
Are you interested in breeding your Golden Retriever? If yes, what would be your reason for breeding?*
Do you understand what a limited registration utilizing a Non-Breeding of Co-Ownership Contract is?*
Comment / Additional Info:

Breeder Relationship
What are your expectations of a breeder?*
Would you be willing to allow us to visit your home?*
How do you feel about maintaining contact with Gold'C'ker Golden Retrievers and providing updates on your dog for his or her life?*
Commitment of Time and Finances
Pets are a lifetime commitment and investment of significant time and money. Vet expenses can unexpectedly climb to many thousands of dollars. How are you planning for this? Are you financially prepared to provide preventative veterinary care, proper diet, training, grooming and exercise for your new Golden for his or her entire life span?*
Additional Information
Have you read the GRCA and / or GRCC websites on acquiring a Golden Retriever?*
Have you read the AKC or CKC Golden Retriever Standard?*
Please list any dog clubs or Organizations of which you are a member.*
Have you had any experience with AKC or CKC Events? If so, please describe. (Obedience Trials and Matches) If not, please indicate any events you would be interested in learning how to compete.*
Are you interested in having someone else show your dog at a CKC or AKC event?*
Would you consider joining Golden Retriever Clubs? If not, why?*
Would you like more information on any of the above questions or topics? Please Specify:*
Comments / Additional Info:

References
Please provide us with two references (name, phone number, and email) of people who have known you and your pets long term.

Please let us know of any other information you wish us to consider. Placing one of our Gold'C'ker Golden Retrievers with you is something we do not take light heartedly. Here is your chance to personalize this application and explain indepth the meaning of having one of our pups.

Photos of your home, yard and family members (animals included) are appreciated as they assist us in getting to know you better and making a selection for you. Photos can be uploaded below. Please remember that we want to make the best fit for our Golden Retrievers and your family. Upon further interview and agreement to requirements and suitability of a Gold'C'ker Golden Retriever, you will be asked for a deposit to confirm your commitment.
Upload photos

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References
Applicants Declaration:

All of the information I / we have given above is true and complete. I understand that submission of this application does NOT guarantee that I will be offered a dog or puppy for purchase, and that Gold'C'ker Golden Retrievers are under no obligation to provide me with a puppy. This application becomes part of our contract should we place a Gold'C'ker Golden Retriever puppy with you.
Electronic Signature:*

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	High	Medium	Low	No interest
House pet
Conformation Showing
Competitive Obedience
Hunting/working tests
Tracking
As a gift
Protection/Guard dog
Service dog
Breeding
Pet Therapy
Agility
Hunting
Hiking
Camping
Jogging
Bike Riding
Flyball
Search and Rescue
Canine Good Neighbor
Kid's playmate

PUPPY APPLICATION

Veterinarian Information

Vaccinations

Your new Golden Retriever

Breeding your Golden Retriever