Is this application for a Foster Home or for an Adoption?
FOSTER HOME
ADOPTION
First name:
Last name:
Spouse name if
applicable: Address:
City: State: Zip Code: E-mail address:
Home Phone:
Work Phone: Occupation(s): Employer's Name: Supervisor's Name:
Supervisor's
Phone:
How did you hear about GCGA?
VISITED WEB SITE
NEWSPAPER/OTHER ADVERTISEMENT
FRIEND
ADOPTED PREVIOUSLY FROM GCGA
REFERRED BY OTHER ADOPTION GROUP
MEET AND GREET (Please specifiy which one in comments
field)
OTHER
COMMENTS:
Why do you want to adopt
a Greyhound? Note: If additional room is needed, there is a comments section at
the end of this form.
If approved,
what age range of Greyhound do you prefer:
UNDER 2 YRS OLD
2 - 4 YRS OLD
4 - 6 YRS OLD
6 YRS OR OLDER
SPECIAL NEEDS GREYHOUND
NO PREFERENCE
Gender preference:
MALE
FEMALE
NO PREFERENCE
Number of adults in your household:
1
2
3 OR MORE
Age range which best describes you:
UNDER 20 YRS OLD
20 - 25 YRS OLD
25 - 30 YRS OLD
30 - 40 YRS OLD
40 - 50 YRS OLD
50 - 60 YRS OLD
OVER 60 YRS OLD
Age range which best describes the next adult in your
household:
NO OTHER ADULTS
UNDER 20 YRS OLD
20 - 25 YRS OLD
25 - 30 YRS OLD
30 - 40 YRS OLD
40 - 50 YRS OLD
50 - 60 YRS OLD
OVER 60 YRS OLD
Age range which best describes any other adults in your
household:
NO OTHER ADULTS
UNDER 20 YRS OLD
20 - 25 YRS OLD
25 - 30 YRS OLD
30 - 40 YRS OLD
40 - 50 YRS OLD
50 - 60 YRS OLD
OVER 60 YRS OLD
Number of children in your household:
NO CHILDREN
1
2
3
4
5 OR MORE
Youngest child's age:
NO CHILDREN
UNDER 1 YR
1 - 2 YRS OLD
2 YRS OLD
3 YRS OLD
4 YRS OLD
5 YRS OLD
6 - 8 YRS OLD
8 - 12 YRS OLD
TEENAGER
OVER 20 YRS OLD
Oldest child's age who lives in the household:
NO CHILDREN
ONE CHILD (ANSWERED BEFORE)
UNDER 5 YRS OLD
6 - 8 YRS OLD
8 - 12 YRS OLD
TEENAGER
OVER 20 YRS OLD
How many hours are the adults away from home on a daily
basis?
UNDER TWO HOURS
2 - 4 HOURS
4 - 6 HOURS
6 - 9 HOURS
OVER 9 HOURS PER DAY
Does everyone in the household agree on adopting a
Greyhound?
YES
NO
Do you have cats?
YES
NO
How many cats?
NO CATS
1
2
3 OR MORE
What are the cats' ages?
NO CATS
KITTEN(S)
KITTEN(S)AND ADULTS
ADULT CAT(S) ONLY
SENIOR CAT
MIXED AGES
Are your cats indoor or outdoor cats or both?
NO CATS
INDOOR ONLY
OUTDOOR ONLY
BOTH INDOOR AND OUTDOOR
Do you currently own other dogs?
YES
NO
How many?
NO DOGS
1
2
3 OR MORE
What are the dogs' approximate ages?
NO DOGS
PUPPY(S)
PUPPY(S)AND ADULTS
ADULT DOG(S) ONLY
SENIOR DOG
MIXED AGES
Are your dogs indoor or outdoor dogs or both?
NO DOGS
INDOOR ONLY
OUTDOOR ONLY
BOTH INDOOR AND OUTDOOR
What breed are your dogs: What size are your dog(s):
NO DOGS
UNDER 25lbs.
25 - 50lbs.
50 - 100lbs.
MIXED SIZES
How long have you owned these pet(s):
NO OTHER PETS
PURCHASED AS A PUPPY/KITTEN
ADOPTED AS ADULTS
BOTH PURCHASED AND ADOPTED
Do you own any other pets?
YES
NO
Species: What other pets have you owned in the last ten years?
Why
are they no longer with you?
NO OTHER PETS
PASSED AWAY - NATURAL CAUSES
RE-HOMED
TURNED IN TO THE POUND
LOST/STOLEN
Please give us the names of two personal references (not
currently residing in your household nor relatives): How do they know you? Reference's phone
number: Reference's
Street Address: Reference's City: State: Zip Code:
Second References' Name: How do they know you? Reference's phone
number: Reference's
Street Address: Reference's City: State: Zip Code:
Please give us your current Veterinarian Name
: Vet's
address: Vet's
phone :
Type of your dwelling:
HOUSE
CONDOMINIUM
TOWNHOUSE
APARTMENT
MOBILE HOME
How long have you lived at your present address?
UNDER 1 YR
1 - 2 YRS
2 - 5 YRS
5 - 10 YRS
OVER 10 YRS
Are you renting?
YES
NO
If
renting do you have your landlord's permission to have a dog over
50lbs?
N/A
YES
NO
Your landlord/complex manager's name : Phone number where they can
be reached: Do
you have a fenced in yard?
YES
NO
If yes, height of fence:
N/A
3ft.
4ft.
5ft.
6ft. PRIVACY FENCE
8ft. PRIVACY FENCE
Please Type Yes or No In The Following
Questions Below:
If you do not have a fenced in yard, are you willing and able to
walk your Greyhound on a leash 3 to 5 times a day to relieve itself?
Do you understand
the importance of keeping your Greyhound on a leash at all times when it is
outdoors in an unfenced area, and are you willing to always abide by that
condition?
Are you willing and able to keep your Greyhound as an inside house
pet? Do you
agree to keep a collar bearing identification on your Greyhound at all
times? Do
you agree to notify GCGA if for any reason you find that you cannot keep your
Greyhound, and do you also agree that you will not give or sell the Greyhound
to anyone without the written consent of GCGA?
Please
list any additional comments that you would like for us to consider when
reviewing your Greyhound adoption application:
By submitting this
application, you hereby certify that the above information is true, complete,
and correct, and you understand that it will be relied upon by GCGA in considering you for Greyhound adoption. You further understand and agree
that this application, if approved, will become part of the adoption agreement
with GCGA.
***Please review your answers carefully
before submitting. Please allow at least up to 5 days from receipt of
application for your follow-up call.***
Once completed, submit your application
on-line, by clicking
below.
OR: Complete entire form; print it
out using your Internet Browser, and FAX it to:
OR: Complete entire form; print it using your Internet
Browser, and MAIL it to:
704-973-7937
Gold Coast Greyhound
Adoptions
Attn: Bill Sharpsteen
PO Box 6501
Clearwater, FL 33758-6501