Return to Adoptable Dogs
Adoption Application
Please print out this form and mail it completed to:
Mary Williams
PO Box 3545
Columbia, SC
29230-3545
Phone: 803-622-1083
Sorry, snail mail only no email.
Name:_______________________________________________Home Phone:_____________
Email address:______________________________________________________________
Address:______________________________________________Work Phone:___________
City:____________________________________State:____Zip:_____________________
Applications without home phone numbers will be discarded.
Referred by:________________________________________________________________
Address:____________________________________________________________________
City:________________________________________________State:____Zip:_________
My veterinarian is:________________________________________________________
Address:___________________________________________________________________
City:________________________________________State:______Zip:______________
1. Type of Dwelling: house condo apartment trailer
2. Do you have fencing (yard, kennel) yes no
If yes: Type: Length: Width: Height:
If no, are you willing to comply with the Rescue's fencing policy?
yes no Comments:
3. Why do you want a Golden Retriever?
4. Have you ever owned a dog?
5. Do you have other animals? List type, age, sex:
6. Do you have children? List number and ages:
7. Where will dog be during day? at night?
8. Are you willing to take the dog to obedience class if necessary? yes no
9. Do you prefer a: male female no preference what age
10. Are you willing to have a member of the Rescue visit your home prior
to adoption (by appointment)?
I will be willing to sign an adoption contract in the best interests
of the adoptive dog. If you are under 18 years old, you must also
have a parent or guardian sign his/her approval.
SIGNATURE DATE:
Revised: 01-11