We realize this Application is very long, but we hope you understand the importance
of each and every question. Your answers to these questions help us determine the
best homes for our Rescue Boxers, and the best Rescue Boxer for your Family.

By applying for the adoption of a Rescue Boxer from Black Hills Boxer Rescue, you hereby give your Veterinarian (s),references and Animal Control Facilities permission to disclose information to Black Hills Boxer Rescue.

If you are applying to FOSTER for BHBR, there are some questions marked for foster applicants. Wherever it states adopt, you may interpret as “foster” and vice versa.

Incomplete Applications will not be accepted. Please be thorough with your answers. Please COPY and PASTE this application into an email to fill it out. Otherwise fill it out and send to us as an email attachment.

Date:

Applicant Name:
Current Address:

Previous Address:

Are you 21 or older:
Home Number:
Applicant occupation:
Personal Email Address:

Co-Applicant Name:
Current Address:

Previous Address:

Are you 21 or older:
Home Number:
Applicant occupation:
Personal Email Address:

Do you live in: House Appt Trailer Other (explain)

Do you: Own or Rent
Boxer Rescue requires a copy of Landlord statement/Lease Agreement for Renters. Please provide Landlord's name and telephone number:

How many adults in home?
Children?
Ages:

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(Veterinarian Reference is required)
Please provide the name, address, and phone number of ALL veterinarians that have
records for the past and present pets, of all applicants:

Please provide the name, address and phone number of your nearest living relative:

Please provide the names, addresses, and phone numbers of two non-related individuals who can serve as references (they must be reachable by phone)
Reference 1)

How long have you known this person?

Reference 2)

How long have you known this person?

May we visit your home and check your references to verify the information you have provided?

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Please list all pets that are currently living in your home(breed, age, sex) and if they live inside or outside:

Are they all spayed or neutered?
If not, explain which animal is not and why:

Are they all current on local/state required vaccinations, rabies and on heartworm preventative, if not please explain why?

Are your pets microchipped?

Are they current on the required licensing in your area?

Please list all pets that you have had in your adult life. (Breed, Sex, Spayed/Neutered) (Inside or Outside Pet) If you do not still have this pet, please explain what happened to the pet:

Have you ever lost a pet to an accident or have one stolen? If so, please describe the circumstances:

Have you ever bred an animal?
If yes, please explain circumstances, how many litters the date(s) and are you still breeding?

Are you involved in showing, agility or obedience?

Do you have any immune-compromised pets?

Are there any special-needs pets in your household?

Do you have any livestock, if so, please list:

Are there other animals or people who regularly visit your home (parent's dog, neighborhood children, relatives, etc.) (We are trying to determine if this is a home with a lot of activity, children, adults and pets visiting or if this is a quiet home with few visitors. It helps us determine what type of dog should be placed there.) Please describe the type of home you have and the number of dog visitors that frequent your home:

What other information can you give us to help us find the right pet for your family, including more about your preferences?

Why are you coming to Rescue for a Boxer? Please take your time and be very explicit for you reason or reasons for coming to rescue to get a boxer. Example; cheaper, already trained, want to provide loving home etc.

How did you hear about Black Hills Boxer Rescue?

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Please list the boxer or boxers that you are interested in adopting/fostering:

Why do you think your home would be best for this particular dog? Please be specific:

Have you previously owned a Boxer?

If not, have you educated yourself about this breed? What do you know about their personality?

Do all members of your household approve of adopting (fostering) a Boxer?

Do any family members have allergies?
If yes, please specify what kind.

Who will be the primary caretaker of this dog?

What are your primary reasons for adopting this pet? Pet Guard Hunting Obedience Other:

How many hours will dog be left alone during the day?

Where will dog be, when no one is home (outside, run of house, garage, inside crated, outdoor kennel etc):

When you are home, where will dog be kept?:

Where will dog sleep?

Where will you keep your dog when you go on vacation or are away from the home overnight?

Do you have a fenced yard?
Describe Fencing (completely contains yard,type of fencing, wood, chain link, height, how many gates etc.)

If no, how will exercise/toilet be handled?

Do you have a doggie door?
Is it open for access by your animals at all times? If no, when is it NOT open to access? (for instance, when you are away from the home, bathing, etc.)?

Do you object to the use of a crate?
If yes, why?

Do you have a crate?

If not, would you be willing to purchase one, if necessary?

Do you have experience with crate training?

Are there any special activities that you would include your dog in? (camping, visiting nursing homes, going to work with you, rides in the car etc.)?

What amount do you expect to pay for yearly veterinarian care, and what would it include? (please give a monetary amount and list the yearly basic care you would provide)

If your rescue dog should develop a serious illness or injury that is very expensive, have you made plans for this, if so, what are they?
(a ruptured ACL can cost up to $2400.00 to repair. Bloat, heart disease, cancer, diabetes are some of the illnesses that our pets can get)

What do you plan to feed your dog? Please be specific as to brand, etc:

How much do you plan on spending on food each month?

Do you plan to "free" feed (leave food out all day) or have scheduled feedings?

Will you groom your dog yourself or use a groomer for bathing, brushing, ear cleaning, nail clipping?

(foster home question)
Would you be willing to foster a dog with health problems and/or special needs?

(foster home question)
Would you be willing to foster more than one dog at a time (littermates or dogs who cannot be separated)?

(foster home question)
Would you be willing to foster a very young dog or a puppy?

(foster home question)
What gender of dog do you prefer to foster?

(foster home question)
Do you have an age preference?
If so, what is that age preference, and what are your reasons having a preference?

(foster home question)
Any size preference? If yes, indicate (indicate size)?

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What kind of behaviors do you expect a rescue dog to exhibit while it is adjusting to it's new home? Please take your time and be very explicit:

Activity Indoors: Some dogs are lively and curious in the house, they like to play with you and follow you around. Some dogs lie down most of the time. Do you think that an active dog will be a problem for anyone in your family?

What type of personality/activity level are you comfortable with in a dog?

What kind of experience do you have in training a dog?

Have you ever taken an obedience class or worked with a trainer?

Do you plan to take an obedience class with your rescue dog?

Some rescue dogs are surrendered because their owners did not put any time into obedience training. Do you know how to teach basic commands?

Will it annoy you if the dog gets up on your sofa or your bed?

If yes, how would you train the dog not to get on the furniture?

What behaviors do you find unacceptable (barking, jumping on people, potty accidents,biting etc:

What will you do if the dog is destructive?

How will you handle it if the dog gets into the garbage?

Some of the rescued dogs have been backyard dogs and are therefore not housetrained. Have you ever house trained a dog before?

Are you comfortable with housetraining a rescue dog?

If your rescue dog is not already housetrained, what housetraining methods do you plan to use with your rescue dog?

Even some dogs who were previously housetrained will have accidents in the house for a while after they come into an unfamiliar home. What steps will you take to help your rescue dog avoid such accidents?

What would you do if the rescue dog did not get along with or chased your pets?

What would you do if the dog started jumping your fence?

What would you consider a reason for giving up a pet? (biting, urinating, moving, divorce, barking, destruction etc):

Have you ever sold; given away; or surrendered an animal to an animal shelter, rescue or other party? If so, provide date(s), city/state, name of shelter or rescue and specific circumstances:

(foster home question)
Many rescue dogs come from unknown backgrounds. In rescue we must assess whether or not the dog has a safe temperament. Many behavioral issues don't show up until they become acclimated to their foster home. Are you experienced in dealing with temperament assessment and feel confident in handling the dog while going through this period?

(foster home question)
We do not adopt out any dog until they have been in rescue for a minimum of two to four weeks for assessment. Many rescues are in foster care for much longer. We do not like to move the dog from home to home while in rescue because this may cause behavioral or psychological issues for the dog. Are you willing to foster a rescue dog for the entire time the dog is in rescue?

(foster home question)
Are you committed to work with your rescue dog through any issue that will help the dog to keep his Forever Home?
**this might include: chasing cats, getting into garbage, jumping on people, trying to run out the front door, digging in the yard, destructiveness, and any other behaviors that have contributed to this dog losing his last home.We do offer a support system and educational materials if needed**

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What are the requirements for dog ownership in your community (licensure, how many you can have, leash laws etc?) (If you don't know, please call and find out so you can answer this question)

Do you live in a neighborhood that has covenants on the size or breed of dog you can have?

Has anyone in your household ever been convicted of a charge relating to cruelty to animals or child abuse?

Is there any such charge pending?

Has any such charge ever been filed?

If yes, please explain and give the disposition of charge(s) and date:



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If you adopt a dog elsewhere or find another dog to foster during this review process, please notify BHBR immediately so we can stop work on your application.

Thank you for taking the time to complete this application. We also thank you for wanting to adopt an animal instead of buying one. By adopting, you can save a life. And, by fostering for BHBR you will be helping a needy rescued dog down the road to finding his or her own Forever Home and lifetime of happiness and love.

Please answer yes or no to each question. Do you agree to the following:
Keep current license and ID tags on dog at all times?
Agree to keep rescue dog on leash whenever it is not in a contained or fenced area?
Agree to never transport dog in open back of a pickup?
Return dog to Boxer Rescue if you can no longer keep or care for dog?
Allow Boxer Rescue agent to visit your home prior to or after adoption?

Signature Waiver
: A) I agree by Initialing __________ that by typing my name in is the same as signing my name to this legal document. B) I give permission for the Boxer Rescue Agent to type my name to this document, causing it to be same as my legal signature on this document. __________ (Applicant's Initials)

Application Usage: Please type YES/NO ___________ if you do or do not want your application shared with other Boxer Rescues for the purpose of adopting or fostering a boxer.

Financial and Physical: I hereby testify that I am financially and physically able to care for this dog. I understand that proper food, veterinary care, bedding, toys, crate and so on can be costly and I am able to meet these requirements. I further testify that I am physically fit to provide all necessary activities with my dog. (Applicant's Initials)_______.

Truthfulness: I understand that if the information contained herein is found to be false, my application can be refused or said adopted dog shall be relinquished to Boxer Rescue without a refund of the Adoption Fee. (Applicant's Initials)_______.

By signing (electronically) below, you attest to the truthfulness of your answers. Falsification of any of the above information will be grounds for denying/rejecting your application. This is a RELEASE OF INFORMATION FORM. You are giving us permission to contact your veterinarian and discuss your records, you are giving permission to contact any organization that is necessary to confirm your answers. To include, animal control agencies, humane societies, rescues etc.

Applicant Signature:
Date

Co-Applicant Signature: Date:

Return completed application to: bhboxerrescue@aol.com

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FOR BOXER RESCUE USE

Date application received by Boxer Rescue:

Comments:

APPROVED:
DISAPPROVED:
Boxer Rescue Representative: