Golden Retriever Puppy Adoption Application

Call/Text/Facetime: (909) 915-7388

Use the links below for more information!

Dam: Radiant Ellie of the Brilliant Soleil- “Ellie” AKC and OFA

Sire: Navalis Yakuza AKC and OFA

Pictures of the Parents!

Video of our puppies on Instagram (Cuteness Overload!)

Puppies will be 1-3 in color shading!
Information & Application for Adoption

Next litter of puppies will be available to take home July/August 2025! Located near Oak Glen, in Yucaipa, California, we provide premium AKC golden retriever puppies to well-deserving folks!
Full Name*

First NameLast Name
Cell Phone Number*

Area CodePhone Number
E-mail*

Confirmation Email
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Ages of all family members in household:*
Occupation of all adults in household:*
Living description :*

Home with fenced yardApartment/condo with nearby green spaceOther
Will the puppy ever be left alone for more than 4 hours per day?*

YesNoOther
When do you want to adopt a puppy?*

As soon as possible3-6 months7-12 monthsOther
Please describe why you would like a golden retriever, your lifestyle, how you plan on caring for him/her, your interest in hobbies and outdoor activities that will include the puppy and any past experience you have with dogs (tell us what makes you a perfect fit for our puppies!)*
By selecting yes, you understand that IF you are approved and you choose to move forward with adoption, there is a deposit of $500 to reserve a puppy and $3500.00 is due on the day you take home your puppy.*

YesNo
By selecting yes, you understand that the puppies are assigned to their new owners based on temperament and personality. Most high-end breeders do not allow people to randomly select their puppies, since we have raised the puppy since birth we know their personalities!*

YesNo
Please describe the temperament and personality characteristics you are looking for in your puppy:*
Would you like a male or female golden retriever puppy?*

MaleFemaleNo preference
Describe where your puppy will sleep:*
Do you have locks and/or latches on all your gates?*

YesNoN/A
Will your adopted puppy ever be put on a tie out/tether?*

YesNoNot sure
Who will have chief responsibility for the care of your new puppy?*
Over the past 5 years, how many pets have you owned? (Include current pets)*
List each pet individually including breed, age, still living with you? (if not, why?)*
Have you ever lost or given away a pet?*

YesNoN/A
Are your present pets up-to-date on their annual vaccines?*

YesNoN/A
Are your present pets spayed or neutered?*

YesNoN/A
By selecting yes, you understand that for health and safety of the Dam and her puppies we do not allow visitors before the pick up day and if you wish to see the puppies we can do that over zoom or FaceTime.*

YesNo
How much are you financially prepared to spend for routine/emergency medical care, licensing, etc?*
What plans do you have for your new pet when you are on vacation?*
Can/Will you provide your dog with monthly heart worm/flea/tick prevention?*

YesNo
If your dog displays behavioral problems (such as jumping on people, excessive barking, potty accidents, etc.) how would you go about correcting the behavior?*

Contact a ProfessionalUse a bookPersonal KnowledgeOther
Please acknowledge that you nor anyone else would ever hit, kick, spank, yell or be aggressive with your dog:*
Is your entire immediate family in agreement with the decision to bring a new pet into your home?*

YesNo
Are you prepared to commit to a pet for 15 - 20 years (average life span)?*

YesNo
Have you or any member of your household ever been charged with cruelty to animals or negligence in animal care?*

YesNo
Where will your dog spend most of his/her time?*
If you selected outdoor, would your dog be supervised?*

YesNo
Please provide your social media addresses and confirm if you are following us on Instagram @GoldenStateRetrievers and on Facebook.*
Please provide 2 personal references (only 1 can be a relative) that can testify to your responsibility and ability to care for your animals. This is required or your application cannot be approved.
Reference #1*
First and Last Name & Relationship to Self
Reference # 1 Phone Number*

Area CodePhone Number
Reference #2*
First and Last Name & Relationship to Self
Reference #2 Phone Number*

Area CodePhone Number
If there is anything else you think we should know, please note it here.
Should be Empty:

Call/Text/Facetime: (909) 915-7388

Information & Application for Adoption

Please provide 2 personal references (only 1 can be a relative) that can testify to your responsibility and ability to care for your animals. This is required or your application cannot be approved.