Boxers and Buddies Adoption Application

* How did you hear about Boxers and Buddies?

* Which dog(s) are you interested in and why are you interested in that particular dog

Personal Information

* Name:

* Age of Adopter

* Street Address

* City/State/Zip

* Home Phone

* Cell Phone and/or Work phone and ext.

* E-mail Address

* Occupation / Employer

* For how long?

* Adults in household: (names and ages)

* Children in household: (names and ages)

* Is anyone in your household allergic to animals?

* Is your entire household supportive of this adoption?

References

* Personal Reference (not related to you)

* Phone Number

* Relationship to applicant / Years acquainted

* Current Veterinarian

* Phone Number and Address

Home Information

* Do you live in a:

* Do you

Renters/Leasees: Provide name and phone number of landlord (required)

* How long at current address?

* Our fence is

We have a

* Do you have a dog kennel/dog run?
If yes, include the measurements:

Pet History

What happened to Past dogs? Please check all that apply

	N/A	Died at 1 - 5 years	Died at 5 - 10 years	Died at 10 - 15 years	Died of natural causes	Put down for heath issues	Put down for behavioral issues	Gave away/sold	Gave/sold to who and why?
Dog #1
Dog #2
Dog #3
Dog #4

* How many dogs have you owned in the last 5 years?

Animals Currently in your home:

	Breed	Sex	Age	Spayed/Neutered	Obedience Trained
Dog 1
Dog 2
Dog 3
Cat 1
Cat 2
Cat 3
Other
Other

What Other Pets are Currently in Your Home?

Dog Information

* Will your new dog be a

* Would you prefer your dog to be: (check all that apply)

* How active is your lifestyle?

* How will you exercise your new dog?

* Where will your new dog:

	In the house	In the garage	In the bedroom	In a crate	Free roam	House w/dog door	Garage w/dog door	Dog run	Yard	Other (specify)
Sleep at night?
Spend time alone?
Spend time when you're home?

* Describe your method of housetraining a dog:

* Descibe how you would discipline a dog:

* For what reasons or for what behaviors would you get rid of a dog?

* What will you do with your new dog on trips and/or vacations?

*

	Yes	No	Other: (specify)
Will you attend obedience classes with your new dog?
Will you return your dog to Boxers and Buddies if you can no longer care for the dog?
Will you allow Boxers and Buddies to visit your home?
Would you be interested in fostering a dog?
Would you like a referral for an obedience trainer?

Further Comments/Additional Information: Anything you feel will help us find the right dog for your home:

*

* Electronic Signature

Your electronic signature below serves as acknowledgement that this is a sincere inquiry, and that all information provided is true, correct and complete.
I understand that this information will be included with my adoption contract and if any of the above information is found to be false, even after adoption, the dog may be reclaimed at no expense to Boxers and Buddies.
I also understand that incomplete applications WILL NOT be processed.
On the Internet an Electronic Signature carries the same legal weight as if you were signing your name to a printed document. To complete this form, please provide your electronic signature below by typing your name in the box, then submit the form.

* Indicates Response Required

Wood	Chain Link
Vinyl	Stone
8 feet	6 feet
4 feet	No fence

Pool (fenced)	Pool (unfenced)
Balcony	Patio (ground level)
Patio (raised)	Deck

Pet	Protector	Kid's dog
Guard dog	Gift	Other

Male	Female	Either gender
Fawn	Brindle	White
Purebred	Mixed	Other(please specify)