Boxer Rescue of Atlantic Canada

Adoption Application
Applicant Name:
Complete Address:
Home Phone Number:
Work Phone Number:
E-mail address:
Have you contacted another rescue? If yes, please list the rescue(s) contacted.:
Have you owned dogs before? If so, were any boxers?:
Do you currently have any dogs?:	yes no
If Yes, what breeds and ages?:
Are they spayed and / or neutered? If not, please list reason(s) why.:
Please list your veterinarian's contact information.:
Any past dogs you don't currently own, please list the reason they're no longer with you.:
Please describe the boxer you are looking for.:
Why do you want to adopt a rescued boxer?:
What are your plans for the dog? Pet, guard, hunting, obedience, show, etc...:
Do you want:	either female male
Do you have a color preference?:	brindle fawn no preference white
What age of boxer are you looking for?:
What is your housing situation?:	own rent
If renting, please provide your landlord's contact information::
In which type of area do you live?:	city country suburb trailer / housing park
Do you have a back yard?:	yes no
What size?:
Do you have a fence?:	yes no
If yes, what type and size?:
Do you have any intention to move in the forseeable future?:
Do you have a kennel available?:	yes no
Do you have a home crate available?:	yes no
If no, do you intend to purchase one? Why or why not?:
How many adults in your home?:
How many children? What are their ages?:
Are the children familiar with dogs?:
How do they react to dogs?:
Is anyone in your home (or frequent company) allergic to animals?:	yes no
Do you have any other pets? Please list with details::
Will your boxer have contact with other pets?:
Please list any potential problems your current pets may have with a new adoption.:
Please describe what your boxer's daily routine would be on a weekday:
How many hours will your boxer spend alone?:
Where will your boxer be when you are at work / errands?:
Please describe what your boxer's routine would be on a weekend.:
How many hours will your boxer spend alone?:
Please describe how you plan on exercising your dog.:
Will your boxer be riding in a vehicle? If so, what kind, how often, and how will he/she be restrain:
Where will your boxer stay if you were away? Short term / long term::
Are there any non-typical circumstances that your boxer will need to adapt to?:
Do you agree to keep current ID AND license tags on your boxer at all times?:	yes no
Do you agree to provide any necessary health care for your boxer?:	yes no
Do you agree to notify and return your boxer to BRAC if you can no longer care for him/her?:	yes no
Do you agree to a home visit prior to adoption, and a follow up visit after?:	yes no
Do you agree to pay an adoption fee for your boxer?:	yes no
Please list your occupation, employer and contact information.:
What is the name of your local animal shelter?:
Please provide a personal reference, with contact information::
Please provide a reference who knows you as a pet owner, with contact information::
Do you feel physically able to care for a boxer for his/her entire lifetime?:	yes no
Do you feel financially capable to provide for a boxer for his/her lifetime?:	yes no
Have the police been to your home for any disturbances?:
Have you, or anyone in your household been charged with animal cruelty?:
Please describe your intended method(s) of discipline::
What do you currently feed your pets?:
Please list any other information you would like to tell us, or have us consider.:
Are you aware that boxers are rough when playing, and can jump to greet people?:	yes no
Are you aware that boxers drool and shed?:	yes no
Are you aware that boxers are prone to separation anxiety, heart problems, and cancer?:	yes no
Are you aware that boxers have a guarding instinct?:	yes no
Are you aware that boxers are needy and require much attention and stimulation?:	yes no
Do you still feel that a boxer is right for you?:	yes no
If accepted, it is your responsibility to arrange to meet the boxer you have been matched with:	I agree I do not agree
Is there a specific dog you are applying for? Please specify:
Please type the text below: