First Name*
Last Name*
Address*
City*
State/Province*
Zip/Postal Code* -
Email*
Cell Phone*
What is your occupation?*
I certify that I am 18 years of age or older.* Choose one: Yes No
Why are you interested in adopting a pet at this time?*
What is the name of your spouse?
What is your spouse's occupation?*
How many adults live in your home?*
Please list the children in the home, their age, and whether they are there full or part time.
Who in the household will care for the pet?*
List at least one reference (who is not a family member)*
Reference Phone Number*
What type of pets do you have currently?
For your current pets, please list Name, breed, age, gender, and if Dog or Cat
Can you provide proof that your pet is spayed or neutered? * Choose one: Yes No Currently have no pets
Can you provide proof that your pet is current on its vaccinations?* Choose one: Yes No
In what type of home do you live?* Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing
Do you own or rent your home?* Choose one: Rent Own
If you rent, have you received the approval of your landlord to have an animal? Choose one: Yes No
If you rent, please enter your landlord's name and phone number:
How many hours will the dog be alone each day?*
Will the animal be kept inside or outside?* Choose one: Inside Only Inside and Outside Outside Only
Where will the animal be kept when you are home?*
Where will the animal be kept when you are not at home?*
Where will the animal sleep?*
Is your yard fenced?* Choose one: No Yard Unfenced Yard Yard Partially Fenced Yard Completely Fenced
What type of fence? Choose one: Privacy Chain Link Invisible None
What is the height of the fence?
Do you have a doggy door?* Choose one: Yes No
Do you have a pool? Choose one: Yes w/fence Yes w/out fence No pool
Do you have a crate? Choose one: Yes (large & wire) Yes (large & plastic airline) Not yet I don't crate
Have you owned a Boxer before? Choose one: Yes No Currently have no pets
Have you ever given up a pet? If yes, please explain:*
Why do you think a Boxer is the right breed for you?*
Veterinarian's name and phone:*
Please indicate if there is a particular dog you are interested in. Choose an animal: Debbie (must be adopted with Doobie) Dutch (must be adopted with Jinx and Jinx) Frank Garth Guinness (must be adopted with Stella and Stella) Jinx (must be adopted with Dutch and Dutch) Li'l Bit Miss Flurry Monte Sansa Scooby Stella (must be adopted with Guinness and Guinness)
I am interested in
Please indicate whether you have a color preference in your adopted Boxer
What age range do you prefer?
Additional information that you think might help us find the right Boxer for you (including more about your preferences and reasons for wanting a Boxer):
Why do you feel that a Rescue Boxer is the right choice for you?*
Why do you feel that you are the right choice for a Rescue Boxer?*
What do you think might be any special considerations when adopting a Rescue Boxer? *
How much do you think it will cost to feed your Boxer in one month?*
What is your definition of disciplining a dog?*
Describe how you will train the pet*
What do you think about obedience training? Please describe your experience(s) or history.*
Do you agree to keep current license and ID tags on dog at all times?* Choose one: Yes No Currently have no pets
Do you agree to timely vet care for your Rescue Boxer?* Choose one: Yes No Currently have no pets
Do you agree to obey all leash laws?* Choose one: Yes No Currently have no pets
Do you agree to never allow your Boxer to ride loose in the back of a vehicle?* Choose one: Yes No Currently have no pets
Do you agree to allow Boxer Rescue agent to visit your home prior to adoption? * Choose one: Yes No Currently have no pets
Do you agree to pay the adoption donation?* Choose one: Yes No Currently have no pets
Do you agree to return your dog to Boxer Rescue if you can no longer keep or care for dog?* Choose one: Yes No Currently have no pets
Have you or anyone in your immediate family ever been convicted of a charge of cruelty to animals? * Choose one: Yes No Currently have no pets
Have you applied with any other rescue?* Choose one: Yes No
How did you hear about us?*
Please select if you are interested in helping Boxer Luv Rescue.
Release Consent: by executing and submitting this adoption form, you consent and grant Boxer Luv Rescue (BLR) the right to contact, request, have released and delivered any and all medical information deemed necessary by BLR from the veterinary doctor's office listed on this adoption form.
By signing and submitting this Boxer Luv Rescue Volunteer Application I am testifying that it, and all accompanying documentation, is true and factual. Boxer Luv Rescue reserves the right to reject any application for any reason at any time. Please enter your name and date.*