Adoption Application

Date:

Are you applying to adopt a rescued Boxer?

What dogs are you interested in and why?

Name:

Name of Spouse/Significant Other:

Street Address:

City/State/Zip:

Email Address:

Home Phone ; best time/place to reach you :

Business Phone:

Mobile Phone

DOB (Must be 21 to apply)

Spouse's DOB:

Do you own or rent?

If you rent, we are required to contact your landlord. Please list landlord's name and phone number:

How long have you lived at the above residence?

Your Employer:

How long have you worked at above listed job:

Do you have children?

Please list gender and age of each child: Child 1:

Do you have any dogs currently residing in your home:

Please list any other pets living in the home (cat, bird, etc.) including age/gender:

Name of past & present Veterinarian and PHONE number:

Are your current pets on Heartworm Prevention:

If so, what brand?

Do you have a yard?

If so, is your yard fenced?

What type/height (chain link/wooden):

If you do not have a fence, what do you plan to do for potty and exercise needs:

Are you able to go home for lunch:

How many hours will the dog be left alone per day:

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

Have you done any research on the Boxer breed, such as health risks and personality traits?

What behaviors do you consider unacceptable in a pet?

Do you have any obediance training knowledge?

Do all members of your family agree upon adoption?

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

Would you consider a silver Boxer (elderly):

Have you applied to any other rescues:

Please list any gender/coat/ear/tail preference:

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

In the past 5 years, have you had any pets that were lost, stolen or given away (if so please explain in detail):

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

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

How were you referred to Blue Ridge Boxer Rescue?

Suggestions/Comments:

If Yes, please list:

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

BLUE RIDGE BOXER RESCUE, INC.

ADOPTION APPLICATION

PO BOX 1855

Hickory, NC 28603

administration@blueridgeboxerrescue.com

Your answers to these questions will help us determine the best homes for our dogs, as well as the best dog for you! By applying for adoption of a rescued Boxer from BRBR, you hereby give your veterinarian and other references permission to disclose information to rescue. Signature is implied and assumed on email adoption applications.

INCOMPLETE APPLICATIONS WILL BE DISCARDED

Any other adults in the household:

Spouse's Employer:

If so, please list name-sex-age-temperament of each pet:

Are your current pets up to date on vaccines:

Are your current pets spayed or neutered:

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

In the past, have you owned any other pets:

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

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

Is anyone in your home allergic to dogs:

Reference # 1:

Reference # 2:

Reference # 3:

Where will the dog sleep at night:

Who will feed-train-care for the dog:

Please list:

Child # 2:

Child # 3:

Child # 4:

Child # 5:

Dog # 1:

Dog # 3:

Dog # 4:

Dog # 5:

Dog # 2:

Pet # 1:

Pet # 2:

Pet # 4:

Pet # 3:

Pet # 5:

**APPLICATIONS MAY TAKE UP TO 2 WEEKS TO PROCESS**

Have you owned a Boxer in the past ?

I am aware that BRBR dogs are placed only as indoor pets & agree to this.

(If no, please do not apply)

If at residence less than 3 months - previous residence and how long there:

If less than 3 months ; previous job and how long there

I am aware that BEFORE I am approved to adopt, I will be visted in my home, by a BRBR Volunteer to determine that my home is a safe positve enviroment for a rescued dog.