Name:
Street Address:
City:
Home Phone#:
Work#:
Cell#:
E-mail:
Date of birth:
Employer:
How did you hear about Richmond Boxer Rescue?
Why is this a good time to adopt?
Why are you interested in adopting a boxer?
What age boxer are you interested in? (please check all that apply)
Puppy (2-8 months) Adolescent (8 months - 2 years) Adult (2-5 years) senior (6 years and older)
Weight:
Gender:
Male Female Either
Are you interested in fostering?
Are you interested in a specific boxer?
Yes No Maybe
What is the name of the boxer you are interested in?
Are you aware that boxers are high energy dogs that require a lot of exercise?
Are you aware of the many health problems that affect this breed?
Are you interested in showing your boxer in obedience, agility, rally, tracking or any other dog sport?
What energy level are you looking for?
How much physical activity can you provide in an average week (this means leashed walks, runs, hiking, agility training, etc. – not playing in the yard)
7+ hours 4-6 hours 2-3 hours less than 2 hours
Who is this pet for?
Myself Family Children Gift Other
If a gift, for whom?
Marital status:
Married Single Partner
Number of adults in household?
Children?
What are the childrens' ages?
Do the children have any experience with animals?
Do you expect to make any major life changes in the next 5 years (moving, children, etc)?
Please list names of any adults living in household and their relationship to you:
Is everyone in the household agreeable to adopting a boxer?
Do you own? Or rent?:
Own Rent
Name of landlord:
Phone#:
Does your lease allow pets?
Yes No
Is their a weight or breed restriction (be specific)?
Do you have a fenced in yard?
Yes No
What type of fence?
How tall?
If your yard is not fenced, how will you handle potty breaks and outside play time?
How do you plan to exercise your boxer?
Where will you keep your boxer when you are not home?
Where will your boxer sleep at night?
Do you have a dog door?
Do you have a crate?
Yes No I plan to get a crate
Do you know the benefits of crate training?
Do you need info and instruction on this?
How many hours a day will your boxer be left alone? (be specific)
Current pets
Other pets (list all pets owned in the last 5 years)
If any of the pets in the home in the last 5 years are or were not spayed/neutered, why not?
Who is your veterinarian?
Name of hospital: phone #
Are all of your pets current on vaccinations and heartworm preventatives? If not, why?
What brand of food do your current pets eat?
Are you willing to accept advice on nutrition?
Yes No
Who will watch your pet when you are out of town or away for the night?
What would happen to your pet if you had to move?
Does anyone in your household have asthma or allergies?
Yes No
Did you have pets before that are no longer with you?
Yes No
What happened to those pets?
Have you ever surrendered an animal to a shelter or rescue?
Yes No
If so, type of animal:
Name of shelter or rescue surrendered to:
Reason for surrender:
Have you ever given a pet away to another individual?
If yes, please elaborate:
Have you ever been reported to animal control, or had an animal removed from your care?
If yes, what happened? (please explain the circumstances and outcome)
What behaviors would cause you to consider giving up a pet?
How would you deal with these behaviors?
Are you willing to attend obedience classes with your adopted dog?
Are you aware that changing homes can be stressful and your adopted dog will likely require time to adjust to a new environment (problems may include adjusting to other pets, housetraining issues, etc)?
Are you open to a home visit before adopting?
Are you willing to maintain contact with RBR after adoption and to contact RBR immediately if there are problems with your adopted dog?
What do you estimate you will spend on this animal in one year (include food, vet visits, medications, etc)?
Please list any other information/education/references that you would like RBR to know about.
By signing below, I certify that all the above information is true, and I recognize that any misrepresentation of facts may result in loss of my adoption privileges. I certify that I have never been convicted of animal cruelty, neglect, abuse, or abandonment. I authorize verification of all statements in this application with listed veterinarian, references and landlord. Richmond Boxer Rescue reserves the right to refuse adoption to anyone who, in its opinion, will not provide a suitable home for this pet. Typing your name in this form will be considered the same as a signature.
Signature:
Date:
Drivers license #:
Boxer Adoption 
