Your home phone number (with area code): Your work phone number (with area code):
Your employer: Your occupation: Please list names and occupations of other adults in the household: Do you have children? If so please list name and age of each: Name of a personal reference: Phone number of personal reference: Years acquainted: Do you have pets currently? If so please list breed, sex and age of each: Are all of your current pets spayed or neutered?: Yes, all pets currently are spayed or neutered. No, all pets are not currently spayed or neutered. If your current pets are not spayed or neutered, why? In the past 5 years have you had any other pets?: Yes, I have had other pets in the past 5 years. No, I have not had other pets in the past 5 years. If you have had pets in the last 5 years, explain why they are no longer with you: 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, I would consider a special needs or a senior boxer. No, I would not consider a special needs or a senior boxer. What are your plans for this dog?: This dog will be a pet. For guarding my home or office. For hunting. I would like a dog for breeding. Other. Please describe: 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 before, why? 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 intend to feed a dog when you adopt?: How do you plan to 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. Do you currently have a veterinarian? Yes, I do have a veterinarian. No, I do not have a veterinarian. If you do have a veterinarian please list their name, city and phone with area code: If you do not have a veterinarian, how do you plan to find one?: Describe your current accomodations: I live in an apartment. I live in a condominium. I live in a single family home. I live on acreage. 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 it?: If you do not have a fence, how will exercise/toilet be handled? Do you own or rent? I own my home. I rent my home. If you rent, do you have permission 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 to verify my permission to have a dog. No, you may not contact my landlord to verify my permission to have a dog. May we visit your home before and after you adopt a dog?: Yes, you can visit my home before and after adoption. No, you cannot visit my home before and after adoption. 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. How long do you plan to keep this dog?: How much money would you consider to be a major medical expense?: Is your entire household supportive of this adoption?: Yes, the entire household supports this adoption. No, the entire household does not support this adoption. If the entire household does not support this adoption please explain why: How did you find out about us?: I found you on a web search engine. I found you on a website link. I found you in a newspaper ad. I found you in a magazine ad. I found you by word of mouth. Other. Please describe: Any additional comments or questions: By clicking on "quotSubmit Application" I am agreeing that the above information is true and correct and understand that this information will be included with my adoption contract and if found to be untrue at any time (even following adoption) the dog may be reclaimed at no expense to Rockin' "P" Rescue, Inc. Further, 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 Rockin' "P" Rescue, Inc. I understand that incomplete applications will not be processed.
Would you consider a special needs boxer or a senior boxer?: Yes, I would consider a special needs or a senior boxer. No, I would not consider a special needs or a senior boxer. What are your plans for this dog?: This dog will be a pet. For guarding my home or office. For hunting. I would like a dog for breeding. Other. Please describe: 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 before, why? 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 intend to feed a dog when you adopt?: How do you plan to 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. Do you currently have a veterinarian? Yes, I do have a veterinarian. No, I do not have a veterinarian. If you do have a veterinarian please list their name, city and phone with area code: If you do not have a veterinarian, how do you plan to find one?: Describe your current accomodations: I live in an apartment. I live in a condominium. I live in a single family home. I live on acreage. 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 it?: If you do not have a fence, how will exercise/toilet be handled? Do you own or rent? I own my home. I rent my home. If you rent, do you have permission 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 to verify my permission to have a dog. No, you may not contact my landlord to verify my permission to have a dog. May we visit your home before and after you adopt a dog?: Yes, you can visit my home before and after adoption. No, you cannot visit my home before and after adoption. 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. How long do you plan to keep this dog?: How much money would you consider to be a major medical expense?: Is your entire household supportive of this adoption?: Yes, the entire household supports this adoption. No, the entire household does not support this adoption. If the entire household does not support this adoption please explain why:
How did you find out about us?: I found you on a web search engine. I found you on a website link. I found you in a newspaper ad. I found you in a magazine ad. I found you by word of mouth. Other. Please describe: Any additional comments or questions:
By clicking on "quotSubmit Application" I am agreeing that the above information is true and correct and understand that this information will be included with my adoption contract and if found to be untrue at any time (even following adoption) the dog may be reclaimed at no expense to Rockin' "P" Rescue, Inc. Further, 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 Rockin' "P" Rescue, Inc. I understand that incomplete applications will not be processed.
