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KENTUCKIANA BOXER RESCUE

"If you pick up a starving dog
and make him prosperous,
he will not bite you;
that is the principal difference between a dog and a man."
-Mark Twain.

Welcome to Kentuckiana Boxer Rescue

If you are interested in adopting a Boxer, please fill out the form below, the information provided will be kept in confidence and only used to determine the suitability of the potential home. Here is a list of the steps we observe in placing our "friends".

Step 1: Complete our on-line adoption application. You must answer all questions, use as much detail as you need. You also must include your physical home address, not a Post Office Box address.

Step 2: You will be contacted by a representative via e-mail to discuss your application. You should expect to answer more questions regarding your application. Our dogs are placed into the most suitable home for each Boxer.

Step 3: After the initial contact mentioned above and if you are approved to move forward with an adoption you will be put in contact with the home visit coordinator. At that time a volunteer will come to your home to meet with your family. Once you are approved, you must be willing to travel to the home of the foster family. You also must schedule a time when your entire family can be present to meet and interact with the dog.

Section I: Applicant Info

Applicant Name:
Email address:
Home phone:
Work phone:
Address:
City, State, Zip:

Section II: Household Info

Total number of people in home:
Please list names and ages of other people living in the home:
Do you own or rent your home? Own Rent
If you rent, please list your landlord's name, phone and address so we can verify you have permission to keep a pet at this address. Landlord's name: Landlord's phone:
How many years have you been at your current address:
Do you have any intention of moving from this address in the next year: Yes No
Is there a fenced area at this location? Yes No If yes, what type of fencing, and how big?:
May we visit your home before and after you adopt a dog? Yes No
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.

Section III: Other/ Prior Pets

Do you have pets currently? If so please list breed, sex and age of each:

Are your current pets spayed or neutered?: Yes No
If your current pets are not spayed or neutered, why?

Have you had other pets in the past?: Yes No

Did you ever give up a pet?: Yes No
If yes, what happened to those pets?

Section IV: Boxer Specific Data

What animal are you interested in adopting (name)?:

Why do you want to adopt a boxer?:

What are your plans for this dog?:
This dog will be a pet.
For guarding my home or office.
I would like a dog for breeding.
Other. Please describe:

Have you ever owned a Boxer before?: Yes No
If so what happened to the Boxer?:

Would the boxer be kept at the same address listed above?

If adopted, where will this Boxer sleep at night?

Who will feed, excercise and train the dog?:

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 No

Do you currently have a veterinarian?
Yes No

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?:

Section V: Additional Information

How long do you plan to keep this dog?:

How did you find out about us?:
I found you on a web search engine.
I found you on a web site 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 "Submit 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 Kentuckiana Boxer Rescue 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 Kentuckiana Boxer Rescue.

I understand that incomplete applications will not be processed.