Adoption Application
Apply Via Email Using MS Word
INSTRUCTIONS:
1. Download File and Save to your computer. 2007 Adoption Application
2. Complete Your Answers using MS Word. Indicate choices by replacing ? with an X.
3. Save.
4. Click to open an email to us. Red Dirt Boxer Rescue
5. Put your FULL name in the subject line where indicated.
6. Attach Your Completed MS Word Document to your Email.
7. Hit Send.
Below is an overview of what is the application you download will look like.
Please Note that ALL questions must be answered before any application goes on to the Adoption Committee. If questions do not apply to you, please indicate that with an N/A.
1. Date: Interested in:
2. Applicant’s Name:
3. Present Address: City: State: Zip:
4. How long at this address? years months
5. Home Phone #: Work Phone #: Cell Phone #:
6. e-mail address:
7. Occupation: __________________________________
8. Do you work? ( )Yes / ( )No
9. Spouse/Significant other’s name:______________________________________
10. Spouse/Significant other’s Cell Phone # ________________________________
11. Spouse/Significant other’s Occupation: _________________________________
12. Does your Spouse/Significant other work: ( )Yes / ( )No
13. How many adults live in the home: _______________
14. Names AND Ages of Adults:____________________________________________
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15. Please confirm that you are over 18 years of age? ( )Yes / ( )No
16. How many children live in the home: ______________
17. Names AND Ages of Children: __________________________________________
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18. I live in a: ( ) House ( ) Duplex ( ) Apartment ( ) Condo ( ) Mobile home ( ) Other:
19. ( ) I rent ( ) I own I have other arrangements:
20. Name of apartment complex or trailer park: Do they allow pets: ( )Yes / ( )No
21. Name of Manager/Landlord: Contact phone #:
22. Any restrictions on pets? ( )Yes / ( )No Explain:
23. Do you have a fenced yard: ( )Yes / ( )No What kind of fence: Height__
24. If you do not have a yard, how do you plan to exercise and potty the dog:_____________________________
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25. Are you planning on moving in the near future: ( )Yes / ( )No
26. If you move, what would you do with your boxer:
27. Will others be handling or caring for this pet: ( )Yes / ( )No If yes, how many Adults Children
28. Do any members of your household have allergies/disabilities/special need? ( )Yes / ( )No
If yes, please explain: _______________________________________________________________________
29. Do you have any other animals: ( )Yes / ( )No
30. Are they spayed or neutered: ( )Yes / ( )No
31. # Dogs: _______ Breed(s): Indoors ( )Yes / ( )No Altered ( )Yes / ( )No
32. # Cats: _______ Breed(s): Indoors ( )Yes / ( )No Altered ( )Yes / ( )No
33. List name, breed, sex and age of each pet you currently own:
__________________________________________/_______________________________________________
__________________________________________/_______________________________________________
__________________________________________/_______________________________________________
34. Are all dogs/cats on heartworm preventative: ( )Yes / ( )No Brand: __________________________________
35. Veterinarian's Name: Location:
36. Phone #: Fax #:
37. Have you had any other pets in your adult life: ( )Yes / ( )No
38. If yes, how long did you own them and what happened to them:
39. Have you adopted any pets from another rescue or animal shelter’s in the past: ( )Yes / ( )No
40. If yes, which one: ______________________________________________
41. What happened to the pet(s):
42. Are you interested in a: ( )Adult ( )Puppy
43. Color of Boxer you prefer:_________________________ Sex you prefer: ___________________________
44. I want this pet for: ( )Breeding ( )Child's pet ( )Gift ( )Companion ( )Hunting ( )Guard dog
( )Working/Farm ( )Companion for other pet ( )Other Explain:
45. How long have you been looking for a boxer: _____________
46. Before seeing the dog that you are applying for, what kind of traits are you looking for in a boxer: _________________________________
47. What is the activity level of the boxer you are looking for:
48. What do you consider undesirable traits:
49. What will you do if the boxer you are applying for displays those undesirable traits or bad behaviors:
_______________________________________________________________________________________
50. What time period would you require to prepare for your new pet: # of days: ( )None, ready now!
51. My pet will be kept mainly: ( )Outdoors ( )Indoors ( )Both, in & out ( )Not sure
52. How long will your pet be left by itself in a 24 hour period: hours
53. When I am gone, my boxer will stay: ( )Outside ( )In a crate ( )In a restricted area ( )free in the house
54. If kept outdoors, what type of shelter will be provided:___________________________________________
55. Do you presently own a dog house: ( )Yes / ( )No
56. Do you tie or chain your pet: ( )Yes / ( )No
57. If you live in the country, how will your dog/puppy be confined:
58. Do you or any of your neighbors have livestock: ( )Yes / ( )No
59. Who will be responsible for the socialization medical care and training of this animal:
60. Would you be interested in attending training sessions: ( )Yes / ( )No
61. Are you interested in information on housebreaking: ( )Yes / ( )No
62. Are you interested in your child(ren) joining the Wiggle Kidz Club: ( )Yes / ( )No
63. Are you interested in information on obedience training: ( )Yes / ( )No
64. Where will your dog sleep at night:
65. What brand of food will your boxer eat:
66. On average, how much do you expect to spend annually on this dog: ______
67. There are times when unexpected and often very expensive medical conditions occur. Are you committed to providing medical care for your adopted boxer: __________________________
68. List your own personal reasons for wanting a dog:
69. Would you be willing to allow a representative of RDBR to visit your residence: ( )Yes / ( )No
70. RDBR does not have a kennel facility and our dogs are located in foster homes throughout the state. How far are you willing to drive to meet the boxer you are interested in: _________________________________
71. Please list three personal references (not related to you): (include name, phone number and relationship to you)
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72. Additional comments:
__________________
Signature Date
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*Your name must be included in the subject line of the email when returning the application.
Example: Jane Doe - Adoption Application
*Please save the document to your computer and attach to an email. Or copy the document and paste it into an email.
*All applications need to be forwarded to (Adopt@RedDirtBoxerRescue.com)
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For office use only
Application was Approved / Disapproved by: ________________________ Date: ____________________ Reason: ______________________________________________________________________________________
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