Applicant Information

Full Name

Email Address

Home Phone

Work Phone

Cell Phone

Street Address

City

State

Zip

Are you employed?

Full-time Part-time Work At Home Retired Student Unemployed

Occupation

Age of Applicant

Household Information and Living Situation

Describe your current living situation:
I live in an apartment.
I live in a townhome or condominium.
I live in a single family home.
I live in a mobile home.
Other
Please describe:

How long have you lived at this address?

Describe your yard:

Is your yard fenced?

My yard is fenced.
My yard is not fenced.

If your yard is fenced, how tall is the fence?

Do you own or rent your home?

I own my home.
I rent my home.

If you rent, do you have permission from your landlord to have a dog? Yes, I do have permission to have a dog.
No, I do not have permission to have a dog.

Landlord's name:

Landlord's phone:

May we contact your landlord to verify that you may have a dog on your property? Yes, you may contact my landlord.
No, you may not contact my landlord.

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

Is anyone in your home allergic to animals?
Yes, someone in the household is allergic to animals.
No, no one in the household is allergic to animals.

Please list names and occupations of other adults in the household:

Are there any children living in your home?

Yes, full-time
Yes, part-time
No

If so, please list their ages:

Is your entire household aware of and supportive of this adoption?

Yes.
No.

If the entire household is not aware of or does not support this adoption please explain why:

Reference and Veterinarian Information

Name of a personal reference (must not live in your home, non-family member, pet owner preferred)

Reference phone number:

Reference email:

Length of acquaintance:

Do you currently have a veterinarian? Yes, I have a veterinarian.
No, I do not have a veterinarian.

If you do have a veterinarian, please list their name, address and phone number:

If you do not have a veterinarian, how do you plan to find one?

Pet Information and History

Do you have pets currently? If so, please list name, breed, sex and age of each:

Are all of your current pets spayed or neutered? Yes
No

If your pets are not spayed or neutered, why not?

Have you had any other pets in the past five years? Yes
No

If you have had pets in the past five years, tell us why they are no longer with you:

Have you ever had to give up a dog? Yes, I have given up a dog.
No, I have never given up a dog.

If you have given up a dog in the past, please explain the circumstances.

Boxer Information

Is there a particular available dog you are interested in? If so, enter the dog's name:

Why do you want to adopt a Boxer?

What research have you done on the Boxer breed?

Describe the dog you are looking for (age, sex, color, etc):

Would you consider a special needs Boxer or a senior Boxer? Yes
No

How long do you plan to keep this dog?

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

What are your plans for this Boxer?
This dog will be a gift.
This dog will be a pet.
For guarding my home or office.
For hunting.
I would like a dog for breeding.
Other.   Please describe:

Who will feed, exercise and train the dog?

If you have dogs currently, what are you feeding them?

If you don't have a dog, what do you plan to feed a dog when you adopt?

How will you train the dog?

Where will the dog sleep at night?

How many hours will the dog be alone each day?

Where will the dog be kept during the day?

Who will take care of the dog in your absence (vacations, emergencies)?

Are you willing to attend an obedience class? Yes, I will attend an obedience class.
No, I will not attend an obedience class.

How will the dog's exercise/toilet be handled?

Miscellaneous

have you been approved or submitted an application with any other boxer rescue groups?
Yes
No
If yes, which rescue?

How did you find out about us?
I found you on Facebook.
Through the meetup group
On a search engine
Petfinder
A link from another website
A newspaper ad
Word of mouth
Previous adopter
Other
Please describe: 

Any additional comments or questions:

We appreciate your patience and understanding throughout this application procedure. Please understand that our goal is to make sure that our Boxers are placed in only the best homes. Please read the following.

Atlanta Boxer Rescue, Inc. ("ABR") has the right to refuse an adoption for ANY reason! The responsibility of ABR is in the best interest of the animal.

By clicking on "Submit Application", I certify that the above information is true. I further understand that if any information on my application changes between this time and prior to adopting an animal, I am required to inform ABR immediately and ABR has the right to reverse my approval and re-evaulate my application. I understand and agree that this adoption placement is conducted solely for the purpose of providing permanent long-term care for the adopted animal. Should a representative of ABR ask to see the animal(s), reasonable access will be granted. If it is determined that the animal(s) are not properly cared for, the animal(s) may be reclaimed by ABR at no expense. Further, I agree to pay any expenses, including legal fees that may be incurred by ABR in the event that the adopted animal(s) placed into my custody are reclaimed by ABR due to neglect or abuse of said adopted animal(s). This application remains the property of ABR and I understand that this information will be included with my adoption contract.

By applying for the adoption of a Boxer, I hereby give permission to my veterinarian, my personal reference and landlord (if applicable) to disclose information to ABR. Only a fully executed contract will complete this adoption.