Adoption FormGoliath Mountain RescuePlease Print Form- Fill Out – Then ReturnDownloadSend Completed FormGoliathMountainRescue@gmail.comYou can also fill out the form below.We look forward to helping assist you with finding your new furry family member.Please enable JavaScript in your browser to complete this form.Applicant Full Name *FirstLastCo Applicant Full NameFirstLastOther Names Used, Including NicknamesFirstLastEmail *Home Address (Where the Dog Will Stay) *Address Line 1Address Line 2CityStateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeContact Phone (Best # to Reach You) *Housing Situation *OwnerRenterIf You Rent, Are You Allowed to Have Dogs in Your Home?YesNoAre There Any Breed Restrictions? YesNoIf Yes to Restrictions, What are the Restrictions? How Many People Live in Your Household? *Are There Children Living in Your Home? *YesNoPlease List the Ages of Any ChildrenAre You Presently Employed? *YesNoPrimary Applicant's Employer?Co-applicant's Employer?If Not Employed, What Resources Do You Have Available to Care for Yourself and a New Dog?What dog(s) are You Interested in? *Have You Had Any Experience with this Breed? *YesNoIf Yes, Please DescribeWhat's Your General Purpose for Getting the Dog? *Family PetGuard DogTell Us a Little About Your Lifestyle, So We May Pair You Up With the Right Dog. *Do you hike, jog, and/or travel?Do you have a lot of social activities at your house?Are you a couch potato? Are You Seeking an Active Dog, Semi-active, or a Very Mellow Dog? *ActiveSomewhat activeNot very activeAny Additional Reasons You are Seeking a Dog? Please Be Specific.Adopted Dog Living Conditions *Indoor OnlyIndoor/OutdoorOutdoor OnlyWhere Will the Dog Sleep? *DoghouseOutsideInsideKennelOtherIf Other, Please Describe.Where Will the Dog Stay in Bad Weather?When You Work, Where Will the Dog Stay and for How Long? *Other than Work, Are There Any Other Major Periods of Time that the Dog Will Be Left Alone? *Do You Currently Have a Veterinarian? *YesNoName of Your Veterinary Clinic or DoctorVet PhoneDo You Currently Have Any Dogs? *YesNoIf Yes, What Breed(s) and Ages?Do You Have Any Other Types of Pets? *NoCatsBirdsHamsters or other types of rodentsReptilesOtherIf Other, Describe Are Your Current Dogs Spayed / Neutered? *YesNoAre Your Current Dogs Up to Date on Their Shots? *YesNoAre Your Current Dogs on a Heartworm Prevention or Wellness Plan? *NoYesDo You Have a Fenced Backyard? *YesNo If Yes, How Tall is Fencing? If Fenced, Do You Lock/Secure Your Gate?YesNo If Yes, Describe. Do You Have a Pool? *YesNoIf Yes, Does a Pool Person Come to Clean It? YesNoDo You Have a Gardener? *YesNoDoes a Meter Reader Enter the Yard Where the Dog May Be? *YesNoAre You Willing to Take Your Dog to Training If Needed? *YesNoIf No, Why?Are You Willing to Work With a Dog on Housebreaking, Chewing, ETC., If Such Problems Arise? *YesNoUnder What Circumstances Would You Chain Up a Dog? *Do You Consider Dogs as a Lifelong Commitment? *YesNoIf No, Please Clarify.Do You Consider Your Dog(s) a Part of the Family? *YesNoIf No, Please Clarify.Under What Circumstances Would You Give Up a Dog? *Is There Anything Else You Would Like to Add or Explain that May Help in the Adoption Process to Help Match the Dogs and You. Your Answer Could Help Us Pair You up with the Best Dog Suited for You?May We Call a Reference? *YesNoFull Name of a Personal Reference. *FirstLast*We will not use this information for any solicitation. It is solely to verify your identity and character for the purpose of adoption.RelationshipReference's Phone # *Email addressPlease Confirm (Read the Disclaimer Below) and Sign. *Clear SignatureBy signing, I/we hereby confirm that I/we are applying for the adoption of a Goliath Mountain Rescue dog and that the statements and answers I/we have provided are true and honest to the best of our ability. I/we are applying for this adoption with the understanding that if I/we are approved for adoption, we will be required to sign a contract with GMR as a lifetime commitment to the care and nurturing of this dog, which requires us to be of legal contract age.Date / Time *DateTimeHow Did You Hear About Goliath Mountain Rescue? Would You Like to Become a Volunteer in Some Capacity?YesNo(If yes, please let us know via email link on the website)We Appreciate Your Interest. Is There Anything Else You Would Like to Add? Please Add Additional Comments that You Think Could Help With this Process.Submit
