Date:
Your full name:
Your email address:
Your occupation:
Your
daytime phone number (please include area code):
Your
evening phone number (please include area code):
Spouse's
name:
Spouse's
occupation:
Reference who has known your animals and you as a pet owner (name and
phone):
Relationship:
Years acquainted:
Do you live in:
house
in the country single family house in town condo
townhouse
apartment
other
If
other, please specify:
Do you rent or own your home? rent own
If renting, are pets allowed? yes no
If allowed, is there a weight limit? yes no
What is the weight limit?
If renting - landlord's name and phone number:
How long have you lived at this address?
If less than 2 years, previous address:
Do you have a fenced yard? yes no
Fence type:
Fence height:
What is the size of your fenced area?
If not fenced,
how do you propose to
handle the dog's exercise and toilet duties?
Do you have a separate kennel run? yes no
If yes, what is the size of the kennel?
Do you have a Doggie Door? yes no
How many adults in the home?
How many children in the home?
The children's ages?
Are any members of your household home during the day? yes no
Do you have other dogs? yes no
How many? Please give breed, sex and age.
Are they all spayed/neutered? yes no
If
not, please tell which are not, and why.
Do
you have any other animals/livestock? yes no
If yes, please list:
Who is your regular veterinarian? (name/phone)
Approximate date of last visit?
Were your animals current on vaccines? yes no
How many dogs have you owned in the last 5 years:
What happened to them? Please list by breed and disposition
(i.e., boxer/still have; boxer/died; dachshund/lost [stolen,
given away, etc.])
If any died - list age and cause
Have you owned boxers before? yes
no
Why do you
think a Boxer is the right breed for you?
What are your plans for the dog?
Pet Guard Hunting Obedience Other
If other, please specify:
What sex do you prefer?
no preference male female
Why?
Age preference:
Why?
Color
preference? No preference brindle fawn white
Are
you willing to consider a boxer mix? yes
no
Which
of our dogs, if any, are of particular interest to you?
Where will the dog spend most of
the day?
Loose indoors
Crate
Basement
Garage
Fenced yard
Loose outdoors Tied up outdoors Kennel run Other
If other, please specify:
How many hours a day will the dog usually be alone?
Where will the dog spend most of each night?
Loose indoors Crate Basement Garage Fenced yard
Loose outdoors Tied up outdoors Kennel run Other
If other, please specify:
When your family is away from home overnight
or on vacation, what will you do with the dog?
Do you understand the adoption fee is usually $190 ? yes no
Do you agree to obey all leash laws? yes no
Do you agree to provide regular health care for the dog(s)? yes no
Do you agree to return the dog to MTBR if you can't keep it? yes no
Would you agree to a housecheck, prior to adoption? yes no
Have you or anyone in your immediate family ever been convicted of a
charge
of cruelty to animals, or are any such charges pending? yes no
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?
How much do you think Veterinary care would cost?
What other expenses would you expect to pay?
What is your manner of disciplining a dog?
Why
are you specifically interested in a RESCUE boxer?
Why do you feel that you would be the right choice for a Rescue Boxer?
What do you think might be any special considerations when adopting a
Rescue Boxer?
How did you hear about Middle Tennessee Boxer Rescue?
If your answer was
Friend/Neighbor/Family Member, please let us know who it was:
(not required, but
appreciated)
If your answer was
"Search Engine," please tell us which one:
Have you contacted any
other boxer rescue groups? yes no
If
your answer was "yes" please list all rescue groups contacted
(including names of contact persons, if you know them):
May
we have your permission to forward your application to other boxer
rescue groups that are closer to you? yes no
By submitting this
form, I swear that all information contained herein is true and
complete.