ECGRR – Application For Adoption – page 3 of 4

IMPORTANT: ALL FOUR (4) PAGES MUST BE COMPLETED FOR YOUR APPLICATION TO BE CONSIDERED
Incomplete/partially completed applications are purged from our system after 24 hours.

Information on this page will further help us match a potential adoptee with your family and home environment. Please be honest – there are no right or wrong answers.

Please note: * indicates a required entry

Reason for Adopting	Briefly (in 20 words or less) explain why you would like to adopt a rescued dog.
Interested in Dog	Was there a particular dog you were interested in? If so, please list the name and ID # here.
Gender	Gender Male Female No Preference Please list the gender of the dog you would like to have.
Age Range	Age Range Under 1 yr old 1 to 4 yr old 4 to 6 yr old 6 or Older Senior No Preference Indicate the age range(s) of the dog you would like to adopt. Multiples may be selected for a larger range. Example: If interested in a 1-6 yr old, select both 1 to 4 yr old and 4 to 6 yr old
Mix or Pure	Mix or Pure GRP-Golden Retriever Pure GRM-Golden Retriever Mix LRP-Lab Retriever Pure LRM-Lab Retriever Mix Doesn't Matter Please indicate if you would be interested in a pure or mix breed. Multiple selections can be made.
Special Needs	Special Needs Yes No Maybe Would you possibly adopt a special needs dog? Examples could include: physical/medical conditions like limited sight/hearing/mobility/health restrictions - Behavioral problems like separation anxiety/thunderphobia - A senior dog that requires special assistance
Primary care of the dog	Who will be primarily responsible for the dog?
Any problems with adding a dog	Any problems with adding a dog Yes No Unknown Do you foresee any problems with adding another pet to the home?