Full Name (required) Email address (required) Home Phone Work Phone Cell Phone Address (City, State & Zip) (required) County (required) Occupation How long at this job? Do you work? From Home Office On The Road Spouse/Significant Other Name Spouse/Significant Other Occupation How long at this job? Does he/she work? From Home Office On The Road Spouse/Significant Other Phone How many adults in home? Names & Ages of Adults How many children in home? Names & Ages of Children Are there any special needs/disabilities/allergies? No Yes If yes, what? Are you working with any other rescue groups? No Yes If yes, who? What best describes your home? (required) Private Home Condo or Townhouse Apartment Co-Op Trailer Other Do you own or rent? (required) Own Rent Provide name & number of landlord How long at this address? Do you plan to move within the next year? Yes No Does your home have a yard? Yes No Is it securely fenced? Yes No N/A Fence height & type If no fence, how do you plan to exercise dog? Do you have any other dogs? (required) Yes No Are they spayed or neutered? (required) Yes No Not old enough Are vaccinations up to date? (required) Yes No Why not? (required) Do you have any cats? (required) Yes No Other pets or livestock? (required) Yes No List name, type, breed, sex & age of your current pets (required) Are all dogs/outdoor cats on heartworm preventative? (required) Yes No Why not? (required) How many dogs have you owned in the past five years? What happened to your last dog? If dog was given away, explain to who and why Have you owned a boxer before? (required) Yes No Why is the boxer the right breed for you? List activities in which you plan to include your dog Age preferred/oldest you would consider adopting Sex of dog you would prefer? (required) Male Female Doesn't Matter Color preference? (required) Any Color White Fawn Brindle Reverse Brindle Would you crop ears / dock tail if it was not already done? (required) Yes No Would you take a mix? (required) Yes No Maybe Are you interested in a particular dog on the site? (required) Yes No Which one(s)? What are your particular preferences for a dog if any, such as: doesn’t get on furniture, must like cats, good with children, etc. Would you consider adopting a special needs dog? (required) Yes No Maybe (i.e. a deaf dog or a dog requiring daily medication) Who will be the dog's primary caregiver? How many hours (on average) will the dog be left alone? What will you do if your dog is destructive while alone? List unacceptable behavior problems How would you discipline your dog? Where will the dog sleep? Check all that apply. (required) Crate Family Member's Bed Garage Fenced Yard Kennel Dog Bed Basement Porch Outside Shelter Dog House Other Would you attend obedience classes with your dog? (required) Yes No Maybe What kind of food do you plan to feed your dog? What would you estimate to be a realistic cost to properly care for your dog for a year? Provide veterinarians name and telephone number for each of your current and prior pets (required) Your application will not be processed without this information (unless you have never had a vet before). What would justify getting rid of a dog? Provide the names & numbers of three (3) personal references, including their relationship to you (required) Comments By checking this box, I have indicated that this is a valid and legal substitution for my written signature on this legal document entitled "Adoption Application." (required) Agree By Checking this box, I state that I am financially and physically able to care for this dog. I understand that proper veterinary care, training and food can be costly, and I am able to meet these requirements. (required) Agree By checking this box I certify my understand that the $350.00 adoption fee will be used for the care of all the dogs within New Jersey Boxer Rescue, Inc., and this fee is non-refundable. (required) Agree By checking this box I certify that all information contained herein is true. If any of the information provided in this document is found to be false, my application can be refused or said dog adopted shall be relinquished to New Jersey Boxer Rescue, Inc. without a refund of monies paid. (required) Agree By checking this box I certify that I am 21 years old. (required) Agree (see NJBR adoption policy, you must be 21 years old to adopt) This field should be left blank Send Please wait...
