Adoption Application

Is there a particular boxer you are interested in and why? *

Why do you want to adopt a boxer? *

Have you ever owned a boxer?*

YESNO

Do you have any upcoming travel plans? If so, when, and for how long?

Full Name*

First NameLast Name

Name of Spouse/Significant Other:

Street Address*

City*

State*

Zip Code*

E-mail*

Primary Phone Number*

Area CodePhone Number

Alternate Phone Number

Area CodePhone Number

Date of Birth*

Date of Birth of Spouse/Significant Other*

Any other adults in the household?*

YesNo

If there are other adults in the household, please list them below

Do you own or rent?*

OwnRent

If you rent, please list your landlord or property owner's contact information below:

How long have you lived at your current residence?*

Do you have any breed or weight restrictions if you rent or with homeowners insurance?*

YesNo

What will happen to your pet if you move?*

Do you have children?*

YesNo

If you have children, please list their names and ages

Child #1:

Child #1 Age:

Child #2:

Child #2 Age:

Child #3:

Child #3 Age:

Child #4:

Child #4 Age:

Child #5:

Child #5 Age:

Are your children used to being around pets?

YesNo

If not, how will you teach your children the correct way to interact with your pet?

Do you have any dogs currently residing in your home?*

YesNo

If you have dogs, please fill in the dog information for each:

Dog #1 Name/Breed:

Dog #1 Age:

Dog #1 Gender:

Dog #1 Temperament:

Dog #2 Name/Breed:

Dog #2 Age:

Dog #2 Gender:

Dog #2 Temperament:

Dog #3 Name/Breed:

Dog #3 Age:

Dog #3 Gender:

Dog #3 Temperament:

Are your current pets up to date on vaccines?*

YesNoDon’t Own Other Pets

Are your current pets spayed and/or neutered?*

YesNoDon’t Own Other Pets

If your pets are NOT spayed/neutered-please explain why?

Are your current pets on Heartworm Prevention?*

YesNoDon’t Own Other Pets

Name of past & present Veterinarian and PHONE number(s):*

Do you have any pets, other than dogs, currently residing in your home?*

YesNo

If you have other pets, please fill in the Pet information for each pet (cat, bird, etc.), age, and gender:

Pet #1:

Pet #1 Age:

Pet #1 Gender:

Pet #2:

Pet #2 Age:

Pet #2 Gender:

Pet #3:

Pet #3 Age:

Pet #3 Gender:

In the past, have you owned any other pets?*

YesNo

If they are not still with you, please explain in detail why:

Do you have a yard?*

YesNo

Is your yard fenced?*

YesNoOther

Do you have an electric fence?*

YesNo

What type of fencing do you have?

What would daily exercise be like for a boxer in your home?*

Where will your boxer be kept during the day when you are unable to be at home (free roam of house/crate/room/fenced area)?*

Where will your boxer sleep at night?*

Who will feed/ train / care for a boxer in your home?*

What is your occupation/employer? *

How long have you been working at your current job? *

How many hours per day does your job take you away from the house? *

What is the maximum number of hours per day you are comfortable leaving a boxer alone for without a break?*

Are you able to provide breaks for your boxer during the day? What would those breaks look like? *

Is anyone in your home allergic to dogs?*

YesNo

Why do think you would be a good match for one of our rescued Boxers?*

What research have you done on the Boxer breed, such as health risks and personality traits?*

Do you have any obedience training knowledge?*

YesNo

What is your training philosophy? How do you plan on training your boxer? *

What types of behaviors do you deem unacceptable or would have a hard time tolerating? *

Do all members of your family agree upon adoption?*

YesNo

Would you consider a special needs Boxer (on medication/blind/deaf)?*

YesNo

Would you consider a senior boxer?*

YesNo

Have you applied to any other rescues:*

YesNo

If yes, please list the rescue(s) here:

Do you have a gender preference and why?*

Have you EVER been charged with animal cruelty or animal neglect?*

YesNo

In the past 5 years, have you had any pets that were lost, stolen or given away?*

YesNo

If yes, please explain in detail

Under what circumstances would you not be able to keep your new dog?: (Examples: new baby, divorce, marriage, new pet, illness, moving, etc)*

Please list 3 personal references whom you have known for at least 2 years (include phone # and email address).

YOU MAY ONLY LIST ONE FAMILY MEMBER AS A REFERENCE; The other 2 references need to be non-related.

**PLEASE NOTE WE CAN NOT COMPLETE YOUR APPLICATION WITHOUT REFERENCES**

Reference #1 Name/Relationship *

Reference #1 Phone Number*

Area CodePhone Number

Reference #1 Email*

example@example.com

Reference #2 Name/Relationship *

Reference #2 Phone Number*

Area CodePhone Number

Reference #2 Email*

example@example.com

Reference #3 Name/Relationship *

Reference #3 Phone Number*

Area CodePhone Number

Reference #3 Email*

example@example.com

How were you referred to The Boxer Rescue, Inc?

If you are approved to adopt; are you willing to assist in transportation to your home?*

Are you willing to allow a 30-60 day adjustment period for your new dog to adapt to your home, your family and any other pets?*

YesNo

Many prospective adopters are surprised at the cost of food and medical expenses that are necessary to keep the animal in good health. Are you willing to make this financial commitment?*

YesNo

Are you willing to make a commitment to this animal for the rest of his or her life?*

YesNo

Do you understand that a dog will take time to adjust to its new surroundings and that certain behavioral issues might occur? This might include housebreaking, separation anxiety,*

YesNo

Additional comments or anything you'd like us to know.

Enter the message as it's shown*

The Boxer Rescue, Inc. Online Adoption Application