Adoption Application


Missouri Valley Boxer Club - Boxer Rescue
Prospective Owner Information
(Please PRINT)

 

DATE: ________________________

NAME: ___________________________________________________________________________

ADDRESS: _______________________________________________________________________

PHONE: HOME _______________________________ WORK ______________________________

E-MAIL ADDRESS: _________________________________________________________________


DOG PREFERENCES:

AGE (Circle one):  Puppy    6-12mo     1-2yr      3-4yr      5-7yr       Senior    No Preference

SEX (Circle one):   Male     Female     No Preference

COLOR (Circle one):  Fawn     Brindle     Reverse Brindle      White       No Preference

FENCING (Circle one):   None     Chainlink (ht:______)     Privacy       Invisible      Kennel/Run  ___X___ft

If you currently do not have fencing, how will exercise/toilet be handled?____________________________

____________________________________________________________________________________

YOUR HOUSING ACCOMMODATIONS:

Describe your current accommodations. Please circle one:

Apartment     Condominium     Single family home     Acreage     Mobile home    

Other (describe) ___________________________________________________________________

How long have you lived at this address? ________________________________

Describe your yard: _________________________________________________________________

If you rent, do you have permission to have a dog?   Yes ____  No ____

Landlord's name: _______________________________ Landlord's phone:_____________________

May we contact your landlord to verify that you may have a dog on your property?: Yes ____ No ____

May we visit your home before and after you adopt a dog?: Yes ____ No ____

HAVE YOU OWNED A BOXER BEFORE?
Yes ____ No ____

When?____________________________________________________________________________

What happened to it? ________________________________________________________________

Age/Cause of death _________________________________________________________________

OTHER PETS OWNED IN THE PAST: _________________________________________________________________________________
 
What happened to them? _____________________________________________________________

ANIMALS IN HOUSEHOLD NOW?  Yes ____ No ____
Please list them along with ages and if they are spayed or neutered

Dogs_____________________________________________________________________________

Cats_____________________________________________________________________________

Other____________________________________________________________________________

ADULTS IN HOUSEHOLD ___________________________Work hours: ______________________

CHILDREN IN THE HOUSE?
Yes____ No ____

Sex/Age:____________________________________________________________________________

Sex/Age:____________________________________________________________________________

Sex/Age:____________________________________________________________________________

PRIMARY CARE

Who will feed and exercise the dog? _______________________________________________________

How will the dog be exercised? ___________________________________________________________

Who will care for the dog in your absence (vacation, emergencies, etc.  ____________________________

___________________________________________________________________________________

VETERINARIAN: _____________________________________ PHONE: ________________________

Why are you interested in owning a boxer?___________________________________________________

____________________________________________________________________________________

How much money would you consider to be a major medical expense? _____________________________

REFERENCES Please provide the names and phone numbers of two people we could contact

1) __________________________________ Phone ____________________________

2) __________________________________ Phone ____________________________


ADDITIONAL INFORMATION

Dogs will be housed? (Circle one)  Indoors     Outdoors     Where when alone? _________________________

Have you ever taken a dog to obedience training? Yes ____ No ____

Are you willing to take obedience classes? Yes ____ No ____

Have you ever crate trained a dog? Yes ____ No ____

Are you willing to crate train? Yes ____ No ____  

Do you own a crate? Yes ____ No ____

Brand _______________________________ Size_____________________________

Any additional information you would like to share about owning a boxer:

 

 


How did you learn about Boxer Rescue?

 


Directions to your home:

 

 

 

 

 

 

__________________________________________________________________________
(For Missouri Valley Boxer Club Rescue use only)

 

Call taken by: ____________________________________________________________________

Caller referred by:_________________________________________________________________

Dogs discussed: _________________________________ Date: ___________________________

Dog seen: ______________________________________ Date: ___________________________

Home interview completed by ______________________________________ Date:____________

NOTES:

 

 

 

 

Dog adopted: ___________________________________ Date:____________________________