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| Adoption Application |
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| Tell Us About You |
| First Name: |
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Last Name: |
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Date: |
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| Address 1: |
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Address 2: |
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| City: |
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State: |
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Zip Code: |
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| Home Phone: |
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Cell Phone: |
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| Age: |
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Occupation: |
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| Work Phone: |
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Work Email: |
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| Spouse/Partner Information |
| Name: |
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| Age: |
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Occupation: |
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| Work Phone: |
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Email: |
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| Other Household Member Information |
| Please list any other adults living in the home: |
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| Gender(s): |
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Age(s): |
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| Are there children in the home: |
Yes
No
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| If so, please list their names: |
Name: |
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Age: |
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Name: |
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Age: |
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Name: |
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Age: |
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| Do you have grandchildren visit frequently or run a day care: |
Yes
No
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| If yes, what will you do with a dog when children are around: |
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| Does anyone in your home suffer from allergies or have special needs that would require a special dog: If so, please explain: |
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| Home/Neighborhood Information |
| Do you currently rent or own your home: |
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| Select home type: |
Single Family House
Apartment
Duplex
Condo/Townhouse
Mobile
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| If you rent, please provide us with the name, address and phone of your landlord. We
verify that pets are allowed. |
| Name: |
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Address: |
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| Phone: |
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| How long at current address: |
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| Do you plan on moving in the future: |
Yes
No
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| Please describe how you will contain the dog while outside, if you having fencing please describe
in detail type of fencing and height: (wood, chainlink, picket, stockate, invisible) |
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| Is your fence shared with a neighbor: |
Yes
No
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| Are gates and entrance/exit points secured: |
Yes
No
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| Please describe your neighborhood: (suburban, city, etc) |
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| If you do not have fencing, how will you exercise a dog: |
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| Current/Previous Pet Information |
| Do you currently have other pets: |
Yes
No
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| If yes, please provide the following information: |
| Pet #1 Name: |
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Type of Pet: |
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Breed: |
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| Age: |
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Sex: |
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Spayed/Neutered: |
Yes
No
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| Vaccinations Current: |
Yes
No
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On Heartworm Preventative: |
Yes
No
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Date of Last Vet Exam: |
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| Pet #2 Name: |
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Type of Pet: |
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Breed: |
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| Age: |
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Sex: |
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Spayed/Neutered: |
Yes
No
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| Vaccinations Current: |
Yes
No
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On Heartworm Preventative: |
Yes
No
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Date of Last Vet Exam: |
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| Pet #3 Name: |
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Type of Pet: |
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Breed: |
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| Age: |
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Sex: |
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Spayed/Neutered: |
Yes
No
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| Vaccinations Current: |
Yes
No
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On Heartworm Preventative: |
Yes
No
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Date of Last Vet Exam: |
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| Have You Owned a Dog Before: |
Yes
No
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| If yes, when: |
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What kind: |
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| Please explain in detail what happened to your previous pets:
(illness, old age, ran away , stolen, accident, put to sleep, etc) |
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| Have you ever had to give up a pet: |
Yes
No
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Please Explain Why: |
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| Have you ever brought an animal to a shelter: |
Yes
No
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Please Explain Why: |
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| Do all of you pets get along: |
Yes
No
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| Where did you get these pets from: |
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| Your Preferences |
| What age dog are you applying for: |
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| What Gender: |
Male
Female
Doesn't Matter
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| Would you consider a pair: |
Yes
No
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| Would you consider a mix: |
Yes
No
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| Purpose: |
Gift
Companion
Family Pet
Other
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| General Information |
| Where will the dog be during the day: |
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In the House
Garage
Basement
Crate
Outside
Kennel
Chained
Room
Other
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| Will the dog have run of the house: |
Yes
No
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| Where will the dog be kept at night: |
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| Number of hours dog will be left alone each day: |
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| Are you willing to work with a dog that is not fully housebroke or is destructive: |
Yes
No
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| What measures will you take: |
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| What do feel is behavior that is not acceptable and how would you discipline a dog: |
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| Are you aware that if circumstances change, you cannot give away or turn into a shelter any
BFBR dog and that it has to be returned to the rescue: |
Yes
No
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| Are you willing to take your dog to obedience training (required): |
Yes
No
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| Are you willing to use a crate if needed: |
Yes
No
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| Are you willing to be patient while a new dog adjusts: |
Yes
No
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| Are you willing to allow a home visit prior to adoption (required): |
Yes
No
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| Are you currently working with another rescue: |
Yes
No
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| Have you ever worked with another rescue: |
Yes
No
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| How did you hear about us: |
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| If you presently have pets that see a vet, please provide the vet's name, address, phone and
account number. Also, print, fill out and mail or fax the veterinary release form allowing us to discuss
your pets with your vet. |
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| Please provide 2 personal references that we may contact: |
| Name: |
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Phone: |
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Relationship: |
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| Name: |
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Phone: |
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Relationship: |
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| Please feel free to use this space to add additional information or comments: |
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| Please note: the following items must be checked and complete or your application will NOT be considered. |
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I am over the age of 21.
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I understand that by checking this box, it is a valid and legal substitution for written signatures on this document titled "Adoption Application".
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I am financially and physically able to care for an animal.
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The information provided by me is true and complete to my knowledge and I understand that if information to the contrary is discovered, it can mean immediate removal of pet acquired through BFBR.
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I understand that any and all information provided by me on this application or on subsequent interviews or home visits is the property of BFBR and will be kept private and confidential.
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I understand that any money paid to Best Friends Boxer Rescue for a pet adoption are non-refundable and go entirely to care for dogs in rescue.
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If you are faxing or mailing this application, please sign in full and date. If you have not heard from someone regarding your application within 3 days, please contact linda@bestfriendsboxerrescue.com. Thank you for considering a rescue dog!
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