Louisiana Boxer Rescue Adoption Application Form


Please fill in the fields below. Optional Fields are marked with an *. We appreciate as much info as possible.
Thank you for your time and consideration for Boxer Rescue!
Thursday, Jul 24, 2008

Your answers to these questions help us determine the best homes for our Rescue Boxers, and the best Rescue Boxer for your Family.
By applying for the adoption of a Rescue Boxer from Boxer Rescue, you hereby give your Veterinarian(s) and other references permission to disclose information to Boxer Rescue.



Name(s):
Home Phone:
E-Mail:
Address:
City/State/Zip:
Occupation:
Personal Reference:
E-Mail:
Years Acquainted:
Phone Number:
Address:
City/State/Zip:
 
Do you live in: House   Appt   Trailer   Other (explain)
 
Do you: Own   Rent


Louisiana Boxer Rescue requires a copy of Landlord statement/Lease Agreement for Renters.

Previous Address:
 
Do you have a fenced yard? Yes   No   -   Kennel run: Yes   No
Describe Fencing/Kennel:
If no, how will exercise/toilet be handled?
How many people in home? Adults:   Children:   Ages:

Are there any family members who need special consideration for any reason? Please explain:*
 
Do you own any other dogs? Yes   No   -   Are they fixed? Yes   No
Breed(s) of Other Dogs:
Sex and Age(s) of other dogs:
 
Any other pets/livestock? Yes   No
List type, sex and age:
 
Who is your current veterinarian?
Address:
Phone:
Name and phone number of any other veterinarians you have used*:
Name and phone number of any Groomers you have used*:
 
How many dogs have you owned in the last 5 years?
Breeds:
What happened to your last dog?
Have you owned a Boxer before? Yes   No
What happened to it/them?

Why do you want a Boxer?
 
What are your plans for this dog? Pet   Guard   Hunting   Obed   Other (Explain) 
 
Do you want:   Male Female Doesn't matter
Do you want: Fawn Brindle White/Check Doesn't matter
Your age preferences: Under 1 year 1 to 3 yrs 3 to 5 yrs Over 5 yrs
 
Where will dog spend most of each day?
Where will dog sleep?
How many hours will dog be alone each day?
Your thoughts on Obedience Training Classes.

Do you agree to the following:
Keep current license and ID tags on dog at all times? Yes   No
Provide timely health care for dog? Yes   No
Restrain dog in open vehicle? (ie back of a pickup) Yes   No
Return dog to Boxer Rescue if you can no longer keep or care for dog? Yes   No
Allow Boxer Rescue agent to visit your home prior to or after adoption? Yes   No
 
What are your thoughts on Crate Training?
Further comments and info that you think might help us find the right Boxer for you, including more about your preferences and reasons for wanting a Boxer*:


Terms of Agreement:
I hereby testify that I am financially and physically able to care for this dog. I understand that proper food, veterinary care, bedding, toys, crate and so on can be costly and I am able to meet these requirements. I further testify that I am physically fit to provide all necessary activities with my dog.

I understand that if the information contained herein is found to be false, my application can be refused or said adopted dog shall be relinquished to Boxer Rescue without a refund of the Adoption Fee.
I understand that the adoption fee of $175 (one hundred and seventy-five dollars) is non-refundable.

I have read and understood and accept the Terms of Agreement.
Date: Thursday, Jul 24, 2008


FOR BOXER RESCUE USE:
Date application received by Boxer Rescue:        /       /
Comments:


APPROVED:                       DISAPPROVED:

Boxer Rescue Representative:

Date:        /       /