Description of your Home:

1. What kind of home do you live in?      Single Family Home Apartment Trailer Townhouse/Condo

2. Do you:     Own Home Rent Live With Parents/Relative

3.  If you rent, please provide the name, address of the Landlord or Relative:                      Phone Number of Landlord/Relative - Required                           

4.  How long at your current address:  Years   Months

5. Are you planning on moving within the next year?    Yes No

6.  If yes, please explain:

7.  Previous Address if less than 2 years at current:

8. Do you have a fenced in yard where you are presently living?    Yes No Partial

9.  If Yes or partial fencing, please provide approximate measurements, height and type of fencing:

10. Do you have a Kennel Run?   Yes No

11. If Yes, please provide approximate measurements of your kennel run:

12. If No, how will dog be exercise & toilet be handled:

13. Which best describes your home?     House in the Country House in the City House in the Suburbs House in a Rural Area

14. What are the requirements of dog ownership in your community? (i.e., licensing, rabies, leash laws, etc.):     

17. If children are present in the home, have they ever been exposed to dogs before?     Yes No N/A

18. Is there anyone in your home with animal related allergies-If so please explain: 

Pets in Home: 

1.  List names, breed and gender of ALL of your current pets (cats, dogs, etc.):

     Pet #1      Pet #2

     Pet #3      Pet #4

     Pet #5      Pet #6

2. Are all dogs spayed or neutered?         Yes No

3. Are all cats spayed or neutered?         Yes No

4. Are all dog in your home up-to-date on Vaccinations or had a titer test with the past year?         Yes No

5. How many other dogs have you owned in the last 5 years?      0 1 2 3 4 5+

7. What happened to your last dog?        Lost Stolen Given Away Other-See Below N/A

     Died-list age and cause:

     Other-please explain:

6.  If your last dog was given away, please explain the circumstance and indicate the name and address of the person to whom the dog now belongs: 

7. Are all of your animals (dogs/cats) on heartworm preventative and flea and tick control?     Yes No N/A

8. If so, what brand?                      

Boxer Knowledge:

1. Have you ever owned a Boxer before?     Yes No

2.  Why do you want a Boxer:   

3. What do you know and what have you learned about the Boxer dog: 

4.  Why would you like to acquire a dog at this time: 

5.  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

6. What are your plans for this dog:  Pet Guard Hunting Obed.

7. How far are you willing to travel to adopt a dog? Under 50 Miles 100 Miles 200 Miles + Doesn’t Matter

Living Environment:

1. Where will dog spend most of the day? Indoors Outdoors

2.  If Indoors: Crate Basement Garage Free run of the house Limited area of house

3.  If Outdoors: Fenced Yard Tethered Kennel Outside Shelter N/A

4.  How many hours will the dog be alone each day: 

5. List your hobbies and activities that you will be including your dog in (i.e., running, boating, biking, walking, hiking, etc):

6.  Is someone home at all times or will the dog need to be alone for a portion of the day: 

7. Where will dog sleep:  Indoors Outdoors

8.  If indoors, where: Crate Dog Bed Family Member's Bed Basement Garage

9.  If outdoors, where: Fenced Yard Kennel N/A

Exercise and Discipline:

1.  How would you exercise your dog:

     Fenced area attached to home-please explain:

     Walks on leash-please explain:

     Other-please explain:

BAR's contract requires that all dogs 1 year old and under attend obedience training.  Other dogs may also require mandatory
training if specified in the adoption contract.

2. Have you ever obedience trained a dog?  Yes No

3. Are you willing to attend Professional Obedience Classes with your new dog if required?  Yes No

4. Would you like a referral for an Obedience Trainer? Yes No

5. Have you ever house trained a dog before?  Yes No

     If yes, please describe your method used to housetrain:

6.  What is your definition of disciplining a dog:

7.  How would you handle a dog's destructive behavior? For example, dog gets into garbage, chews on shoe, etc:

Food and Other Expenses:

1.  How much do you think it would cost to feed the dog a month:

2.  What brand of dog food would you use and how much:

3.  What costs are involved in routine veterinary care for a dog:

4.  What other expenses would you expect to pay:

Other:

1.  What would you do if you could not keep the dog:

3. Are you currently working with any other Boxer Rescues? Yes No

If yes, please provide the name, phone number, and e-mail address so that we may collaborate our efforts:

4. Do you agree to have dog neutered/spayed within 30 days of adoption if not already done? Yes No

5. Do you agree to keep current license and ID tags on dog at all times? Yes No

6. Do you agree to provide timely health care for dog? Yes No

7. Do you agree to restrain dog in open vehicle? Yes No

8. Do you agree to return dog to Boxer Rescue if you can no longer keep or care for dog? Yes No

9. Do you agree to allow a Boxer Rescue agent to visit your home prior to adoption? Yes No

10. Would you be interested in fostering a Boxer prior to adopting it? Yes No

11. Why do you feel that a Rescue Boxer would be a right choice for you? 

12. Further comments or additional information that you feel might help us find the right Boxer for your home:

13. Please let us know how you heard of our organization? Internet Search Engine Petfinder.com Friend/Family Member Boxer Expo Day - BAR Representative Other Shelter/Rescue Organization Met Former Adopter

14.  Although it is not a requirement for adoption, would you will willing, post adoption, to volunteer to help other Boxers
in need
in any of the following ways?

        Transporting   Yes No                     Interviewing   Yes No                  Reference Checks   Yes No

        Fostering        Yes No                     Home Visits   Yes No                  Attending Expos     Yes No

        Fundraising     Yes No                     Other - Please Specify  

The adoption process generally takes 2 to 3 weeks to complete.  Dogs that appear on our Web Site today, may, or may not
be, available by the time the process is completed and you are approved to adopt.  Please list the name(s) of any current
dog(s) on our site that you may be particularly interested in?:

Please enable your computer to receive emails from:  boxerangelsdirectors@yahoogroups.com and from our placement
coordinator:  Gail@degraffbloom.com

If all important questions are not answered, you will be directed back to each one of them individually to complete before
application can be submitted.

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