Personal Information
* = Required Field
*I am Interested in	Adopting a Boxer Fostering a Boxer Volunteering with Boxer Luv
*Your Name:
*Street Address:
*City:
*State:
*Zip Code:
*Home Phone:
*E-Mail Address:
*Occupation:
*Employer:
*Work Phone:
Spouse's Name:
Spouse's Occupation:
Spouse's E-Mail Address:
References
*Personal Reference Name:
*Personal Reference Phone:
*Years Acquainted:
*Reference who has known your animals, and you as a pet owner:
*Reference Name:
*Reference Phone:
*Years Acquainted:
*Relationship:
Information On Lodging:
*Which of these do you live in?	House in the Country   Single family house     Townhouse  Condo Apartment Trailer
Describe other:
*Do you:	Own Rent
If renting are pets allowed:	Yes No
Is their a weight limit? If yes, what is the limit?	Yes No Weight Limit
*Previous Address:
*City:
*State:
*Do you have a fenced yard?	Yes No
Fence type:
Fence height:
What is the size of the yard?
*Do you have a separate kennel run?	Yes No
Describe kennel fencing:
Kennel Size
If you have no fence or kennel, how will exercise/toilet be handled
Family Situation
*How many adults in the home?	* Children?
Children's ages?
*Are any members of your household home during the day?	Yes No
*Do you own any other dogs?	Yes No
How many other dogs?
Are they spayed/neutered?	Yes      No
Breed of Other Dogs:
Ages of Other Dogs:
Sexes of Other Dogs:
*Do you own any cats?	Yes      No
How many cats?
*Are your pets current on their vaccinations?	Yes      No You will be asked to provide proof of spay/neuter.
Any other pets/livestock?	Yes      No
List type and age
Veterinarian
*Who is your veterinarian?
*Veterinarian's phone number:
*Aproximate date of last visit:
*If no regular vet, would you like a referral?	Yes      No
General Infomation
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 think a boxer is the right breed for you?
*What are your plans for this dog?	Pet Guard Hunting Obedience Other
Other plans:
Do you want:	Male Female Either
Why?
Do you want:	Fawn Brindle White/check Any
Your preference as to age:
Would you consider another sex, age, color?	Sex Age Color
*Where will dog spend most of each day?	Indoors Fenced yard Crate Basement/garage Tethered Kennel Other Other place:
*Where will dog sleep?	Indoors Fenced yard Crate Basement Garage Kennel Other Other place:
*How many hours will dog be alone each day?
*How many hours will you spend with your dog each day?
*If you have to move in the future, what will happen to your dog?
*When your family is away from home overnight or on vacation, what will you do with the dog?
*Why do you feel you would like to acquire a dog at this time?
*How much do you think it would cost to feed the dog (per month)?
*How much do you think veterinary care would cost? (per month)?
*What other expenses would you expect to pay?
*What is your definition of disciplining a dog?
*Why do you feel that a Rescue Boxer would be a right choice for you?
*Why do you feel that you would be the right choice for a Rescue Boxer?
*What do you think might be any special considerations to consider when adopting a Rescue Boxer? What are your thoughts on obedience training classes?
Do you agree to the following
*Spay/Neuter within 30 days?	Yes     No
*Keep current license and ID tags on dog at all times?	Yes     No
*Provide timely health care for dog?	Yes     No
*Do you allow your dog to ride loose in the back of an open vehicle?	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 adoption?	Yes     No
*Do you agree to pay the spay/neuter fee if applicable?	Yes       No
*The adoption fee?	Yes       No
*Obey all leash laws?	Yes     No
*Have you or anyone in your immediate family ever been convicted of a charge of cruelty to animals?	Yes     No
*Are any such charges currently pending?	Yes      No
*Further comments and information that you think might help us find the right Boxer for you, including more about your preferences and reasons for wanting a Boxer:
*How were you referred to Boxer Luv Rescue?	Newspaper Ad Petfinder Pets911 Boxerworld Search Engine Word OF Mouth
Other
*Have you applied to any other boxer rescue?	Yes No
If Yes, name of rescue?
By submitting this Central & Northern Arizona Boxer Rescue Application you are testifying that it, and all accompanying documentation, is true and factual. Central & Northern Arizona Boxer Rescue reserves the right to reject any application for any reason at any time. This application must be filled out in its entirety.  Incomplete applications will not be considered

        
 

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