Adoption Application

NEW YORK STATE RETRIEVER RESCUE, INC. 501C(3)

NYSRR Adoption Application

PLEASE NOTE: We prefer to adopt dogs in the Long Island/NY Metro Area (approximately 60 mile radius). Why, because that is where our volunteers, veterinarians, trainers and other professionals are primarily located. Many of dogs come from our partner in Louisiana. This makes it difficult to set up a meet n greet with your dog and/or family - so please consider this before applying. Your first meet could be at transport.
Adoption Fees: Puppies less than 12 months $650, dog under 8 years $550, over 8 years of age is $275

Name *

First

Last

Address *

City, State, Zip *

Email *

Home Phone Number *

Cell Phone Number *

Work Number *

If you work, hours of employment, including commute? *

Number of ADULTS & ages living in your household. *

If there are CHILDREN living in the household, what are their ages? *

Name of dog(s) you are interested in? *

Breed of Dog Preferred: *

Golden Lab Any

Preferred Sex of dog: *

Male Female either

Preferred age range: *

Why do you want to adopt a Rescue dog? And how will it fit into your lifestyle? *

What are the most important responsibilities in owning a dog? *

Would you consider a dog with one of the following special needs: *

Senior (8 years or older) Simple medical issues (i.e., Daily medication, recovering from surgery) None of the above

How long do you expect it will take your new dog to adjust to his/ her new home? *

How much training are you prepared to do with a dog? *

None to minimal Some (i.e., jumps on people, pulls on leash, digs in yard) Extensive (i.e., no basic training, does not get along with dogs, destructive)

Are you willing to housebreak a dog, do you understand that changing a dog's environment may cause the dog to have accidents? *

Yes No

If you are applying for a puppy/ dog that is not housetrained, how will you housetrain the dog? *

If a behavioral problem arises, would you be willing to take the dog to obedience training? *

Yes No Not sure

Describe the kinds of personal situations where you might need to return your adopted dog; i.e. job change, moving, birth of children, etc. *

Would you be willing to obtain the appropriately sized, open wire crate, if recommended? *

Yes No Already own

PETS:

Please list all pets currently living in your household: Name, Type, Age: *

Please list any pets you have had that are no longer living in your household: Name, Type, Age, why no longer with you. *

List each vet/animal hospital where your pet(s) received care over the last 5 years:

Vet's Name *

Vet's Phone Number *

Pet(s) seen: *

Date of last visit: *

Name of Vet you will use for your new pet: *

Vet's Phone Number *

Do you own or rent your residence? *

Own Rent

If rented, what type/size pets are permitted? *

Landlord's name *

Landlord's Phone Number *

Do we have your permission to contact landlord? *

Yes No

What is the size of your lot? *

Does the fencing completely enclose the yard? *

If you have no fence, do you plan to install one and what type? *

Do you have a tie-out or runner for the dog? *

Yes No

Describe the circumstances in which you would walk/exercise a dog ON LEASH: *

Describe the circumstances in which you would walk/exercise a dog OFF LEASH: *

How often will you exercise the dog and for approximately how long? *

When you are at home , where will the dog be kept? *

How many hours will the dog be left unattended? *

When no one is home (i.e., shopping, work, etc.) where will the dog stay? *

What will you do with the dog when you travel? *

If you have to move, what will you do with the dog? *

Is everyone in your family in agreement about adopting a dog? *

Yes No

Are you aware that New York State Retriever Rescue requires all dogs/cats in the home to be spayed/neutered? *

Yes No

Are you willing to have a representative of New York State Retriever Rescue visit your home prior to adoption (by appointment)? *

Yes No

Are you aware that the minimum adoption donation for puppies less than 12 months is $650, a young dog, under 8 years of age is $550, and over 8 years of age is $275? *

Yes No

New York State Retriever Rescue reserves the right to check references. Please provide the names & phone numbers for two individuals, not related to you and include how you know them. (ie: Neighbor, friend, co-worker) *

Many of the dogs that NYSRR rescues come from out of state. We pay transport to bring these dogs to the Northeast. There are scheduled stops along the route. To assist rescue, we are ask Adopters/Fosters to meet the transport at these designated locations for pet pick up. Depending on where you live, pick up sites can be 50 miles or more. Are you willing to pick up a dog from transport?

Willing to pick up a dog from transport? *

Yes No

How did you hear about NYSRR? *

Any additional comments, questions? Additional Pet information, Vet information? *

Once all questions are filled in and you click "Submit" you will get a confirmation thanking you for your application.
If you encounter an error, especially when using Chrome, please try to clear your cache - here is a link to assist in doing that http://www.refreshyourcache.com/en/home/. If you continue to have problems, please send us an email at NYSRR@yahoo.com

Submit

If you have any questions and/or problems filling out the application please email us at nysrr@yahoo.com .
Thank you!