Application to Adopt or Foster

Denotes required fields.

Personal information:
First Name:	Last Name:
Age:	Email:
Street address:	City:
County:	State / Zip:	/
Area Code & Phone#:	Other Contact#:
Our application process is handled through both email and phone contact. What is the best number and time to reach you by phone? If you do not have email access please note that here.

Other household information:
Other adults in the household include name, age and occupation:
Children in the household including name and age:
Living Situation:		Rent Own
If you rent, please provide your landlord's name, address and telephone number:
If you own, what are the requirements for dog ownership in your community?
How long at current address?
Is your yard securely fenced?		Yes No
If not, how will the dog's bathroom exercises be handled?

Current Pet Information:
Yes I current have a pet(s). If checked, information on at least one pet is required.
#1 Name:
Age:		Sex:
Weight:		Breed:
Spayed/Neutered?		Vaccinations current?
On Heartworm Preventative?		Date and reason for last vet visit:

#2 Name:
Age:		Sex:
Weight:		Breed:
Spayed/Neutered?		Vaccinations current?
On Heartworm Preventative?		Date and reason for last vet visit:

#3 Name:
Age:		Sex:
Weight:		Breed:
Spayed/Neutered?		Vaccinations current?
On Heartworm Preventative?		Date and reason for last vet visit:

What would you consider a realistic cost to properly care for a dog for one year? Please explain:
What other expenses would you expect to pay? Please be as specific as possible:
If you have additional pets, please provide the details:

Previous pet information:
How many dogs have you owned in the last five years?
What happened to your last dog?

Boxer Preferences:
Age:		Gender:

Ears:	Cropped:		Natural:		Doesn't Matter:
Tail:	Docked:		Natural:		Doesn't Matter:

Would you consider a Boxer with special needs or a disability?
Would you consider adopting more than one Boxer?

Anticipated Plans and Daily Routine:
What are your plans for the dog? At Least one plan is required.

Pet	Guard	Hunting	Obedience
Breed/Stud	Agility	Therapy	Schutzland
Other (specific):

How many hours per day will the dog be left alone?
Where will the dog stay when you are away from home?
Where will the dog sleep at night?
If the dog is used to being crated, will you provide a crate?
What will you do if your dog is destructive while left alone?
List the types of behavior problems that you consider NOT acceptable:
What is your definition of disciplining a dog? Please provide examples:
Have you ever obedience trained a dog before?
Are you willing to attend obedience training with your dog?
How will you exercise your Boxer? How often? Please explain in detail:
How long do you think it will take a rescue dog to become adjusted to your home?
Are you willing to deal with housebreaking issues that sometimes occur with Rescue dogs?
What will your Boxer's eating schedule be?
Are you currently working with any other rescue groups? If yes, please list them:
How did you hear about Boxer Aid & Rescue Coalition (BARC)?
Do you agree that if you are ever unwilling or unable to keep a Boxer received through rescue the dog MUST be returned to the rescue?
What circumstances, in your mind, justify getting rid of a dog? Please be as specific as possible:
At what point would you consider euthanasia?
Do you agree to allow BARC to conduct a pre-adoption home visit?
Additional information or comments:

Veterinarian Information:
Name:
Address:
Phone number:

Please indicate which dog you are interested in:
Dog name:
If there is no specific dog at this time, please leave menu set to "Select Boxer". Please keep in mind that we have new dogs coming in for evaluation on a regular basis.

You must meet all of the following below in order for your application to be processed: [Please Initial]
I certify that I am at least 21 years of age.
I agree that this is a valid and legal substitution for written signature on this legal document titled "Adoption Application"
I am stating that I am financially and physically able to care for this dog. I understand that proper food and veterinary care can be costly and I am able to meet these requirements:
I understand that if the information contained herein is found to be false my application can be refused or said dog adopted shall be relinquished to BARC without a refund of monies paid.
I understand that should I adopt from BARC, the adoption fee in its entirety goes toward the care for all of the rescue dogs and that this fee is nonrefundable.
I understand that if I am outside the coverage area of Boxer Aid & Rescue Coalition, Inc., (North Florida and South Georgia), my application will be forwarded to another Boxer rescue group who services my location.

Signed:
Date:	07/29/2010

Any information obtained from you through our website or forms will not be sold or given to any third party without your permission.

This form is adapted from one created by Second Chance Boxer Rescue and is used with their permission. Modified for Boxer Aid & Rescue Coalition, Inc. by Cle Cooks.