Adoption Application
First Name
Last Name
Address
City
State
Zip/Postal
County
Home Phone
Cell Phone
Work Phone
Email Address
Occupation
Do you work?
Spouse/Significant other's name
Spouse/Significant other's job
Spouse/Significant other's phone
Spouse/Significant other's cell phone
Does he/she work?
How many adults in home?
Names/ages of adults
How many children in home?
Names/ages of children
Are there any special needs/disabilities/allergies?
Are you working with any other rescue groups?
If yes, who?
What best describes your home?
Do you own or rent?
How long at this address? (years/months)
If you rent, provide name and phone number of landlord
Do you plan to move withing the next year?
Does your home have a yard?
Is it securely fenced?
Fence height/type
If no fence, how do you plan to excercise your dog?
Do you have any other dogs?
Are they spayed/neutered?
Vaccination up to date?
Do you have any cats?
Other pets or livestock?
List name, breed, sex and age of each of your current pets
Are all dogs/cats on heartworm preventative?
How many dogs have you owned in the past five years?
What happened to your last dog?
If last dog was given away, explain to who and why
Have you owned a Boxer before?
List activities in which you plan to include your dog
Age preferred/oldest you would consider adopting
Sex of dog you prefer
Would you consider a mix?
Color Preference
(hold down Ctrl for multiple selection)
Boxer you're interested in
Would you consider other Boxers or a different sex from your selected preferences?
What are your particular preferences for a dog if any, such as: "doesn't get on furniture", "must like cats", "good with children", etc.
Would you consider adopting a special needs dog (i.e. a deaf dog, or a dog requiring daily medication)?
Who will be the dog's primary caregiver?
Where will the dog stay during the day?
How many hours (on average) will dog be alone?
What will you do if your dog is destructive while alone?
List unnacceptable behavior issues
How would you discipline your dog?
Where will your dog sleep?
(hold down Ctrl for multiple selection)
Would you attend obedience classes with your dog?
What kind of food do you plan to feed your dog?
What would you estimate to be a realistic cost to properly care for your dog for a year?
Provide veterinarian's name and telephone number for each of your current and prior pets
  Pet Name Vet Name Phone Number
1.
2.
3.
What would justify getting rid of a dog?
Please provide three personal references (not related to you)
  Name Phone (plus area code) Relationship
1.
2.
3.
Your Comments
By checking this box, I have indicated that this is a valid and legal substitution for my written signature on this legal document entitled "Adoption Application."
By checking this box, I state that I am financially and physically able to care for this dog. I understand that proper veterinary care, training and food can be costly, and I am able to meet these requirements.
By checking this box, I certify my understanding that the $300.00 adoption fee will be used for the care of all the dogs within Homeward Bound Boxer Rescue, Inc. , and this fee is non-refundable.
By checking this box, I certify that all information contained herein is true. If any of the information provided in this document is found to be false, my application can be refused or said dog adopted shall be relinquished to Homeward Bound Boxer Rescue, Inc. without a refund of monies paid.
Check this box to have a copy of this Application e-mailed to you.
 
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