Contact Us

City: State: Zip:

Have you ever had a dog before? Yes No
...if yes, which breed?

Does your house have a fenced yard? Yes No

Is someone home a good part of the day and night? Yes No

Do you have children? Yes No
...if yes, how old? 0 - 2 3 - 5 6 - 9 10 - 12 13 - 17
...Have they had experience with dogs before? Yes No

Why do you want a Golden?

Have you identified a local vet who you will either use or have used? Yes No

Do you intend to neuter or spay? Yes No

Are you a member of a local Golden Retriever Club or would you be interested in joining one? Yes No

Are there any activities that you would like to participate in with your Golden? Such as Conformation, Obedience, Field Work, or Agility? Yes No