This updated information will allow us to match your family with the "perfect" dog for you. You will not have to go through a phone interview, and the only reference we will be checking with is your current veterinarian. You will only need a new home visit if you have moved since last being approved. Thank you for your cooperation.
General Information:
Name:
Address:
City: State: Zip:
Email:
Home Phone: Cell Phone:
Best time and place to reach you:
Spouse/Significant Other's Name:
Name of dog you previously adopted from BAR: Date of Adoption:
Name, Address and Phone number of your current veterinarian. If you do not have any pets currently, but did, please provide previous veterinarian information.
Have you moved since previously adopting from BAR? Yes No
Do you have a fenced in yard where you are presently living? Yes No Partial
Please list the names and ages of all person's over 21 living in the home including yourself:
Please list the names and ages of all full-time and part-time residents in the home who are under 21 years of age:
Pet Information:
1. List names, breed and gender of ALL of your current pets (cats, dogs, etc.) and please note which one was adopted from BAR:
2. Are all dogs spayed or neutered? Yes No
3. Are all dog in your home up-to-date on Vaccinations or had a titer test with the past year? Yes No
4. Are all of your animals (dogs/cats) on heartworm preventative and flea and tick control? Yes No N/A
5. Why do you want a Boxer to adopt another Boxer at this time?
6. Describe the type of dog you are looking for:
Gender? Male Female Doesn’t Matter Coloring? Fawn Brindle White Doesn’t Matter
Style Of Ears? Natural Cropped Doesn’t Matter Style Of Tail? Docked Natural / Long Doesn’t Matter
Would you consider adopting a dog with a treatable medical condition (heartworm)? Yes No Doesn’t Matter
Would you consider adopting a dog with a permanent medical condition (blind/deaf/missing limb)? Yes No Doesn’t Matter
Would you consider adopting a Boxer Mix? Yes No Doesn’t Matter
What age dog are you looking for?: Under 1 year 1-5 years Over 5 years Doesn't mater
Is there any Boxer presently on our web site that you are interested in?:
7. Is someone home at all times or will the dog need to be alone for a portion of the day:
8. Are you currently working with any other Boxer Rescues? Yes No
9. If yes, please provide the name, phone number, and e-mail address so that we may collaborate our efforts:
10. Do you agree to allow a Boxer Rescue agent to visit your home prior to adoption if you have moved since previously adopting? Yes No
11. Do you agree to provide professional obedience training for a new Boxer if required? Yes No
12. Would you be interested in our new Foster-to-Adopt Program? Yes No Information is available about the FTA Program at: http://www.boxerangelsrescue.com/FTA%20Program/fostertoadopt_program.htm
13. Further comments or additional information that you feel might help us find the right Boxer for your home particularly any changes that have taken place in your home since you last adopted:
Please enable your computer to receive emails from: boxerangelsdirectors@yahoogroups.com and from our placement coordinator: Gail@degraffbloom.com
Please allow time for the application to be transmitted. If you application was transmitted successfully, you will receive a "Form Confirmation" which we suggest that you print out for your records. If you do not get this confirmation form, hit the back button to go back to your application and submit it again.
Back to Site Map Back to Home Page