Foster to Adopt Application

 

Applicant Information

Your First Name
Your Last Name
Age
E-mail
Street Address
City
State
Zip Code
Area Code
Phone Number

How would you prefer to be contacted?
Best time to contact
 

Applicant Employment Information

Your Occupation
Employer
Length of Employment
Work Phone (including ext)
Work E-mail
Cell Phone
Other contact info
 

Applicant House Mates

How many adults, other than yourself, live in your home?
Adult 2's Name
Adult 2's Age
Relationship to you
Adult 2's Occupation
Adult 2's Employer
Adult 2's Length of Employment
Adult 2's Work Phone (including ext)
Please list any other adults living in your home
 

Children or Special Needs

How many children in home?
Please list all children living in your home (list name and age)
Are there any household members who need special consideration for any reason? (uses walker, in wheelchair, autistic, seizure disorder, hearing/visually impaired, mentally challenged, etc.) Yes | No
Please give name and age of individual, relationship to you, and a thorough description of their special needs
 

Applicant References

List 2 Personal References, not related to you and not living in your home. (Knowledge of household's experience with dogs is a plus.) (Please let references know you would appreciate their talking with Boxer Rescue representatives when contacted and if Boxer Rescue leaves message on phone or sends e-mail to please respond as soon as possible to speed processing of your Application to Adopt.)
Reference 1 Name
Reference 1 E-mail
Reference 1 Relationship to you
Reference 1 Phone Number(s)
Reference 1 Best way and time to contact
Reference 2 Name
Reference 2 E-mail
Reference 2 Relationship to you
Reference 2 Phone Number(s)
Reference 2 Best way and time to contact
 

Applicant Residence

Do you live in Home | Apartment
If Other please Explain
Do you own or rent Own | Rent
How long have you lived at this address (please list in years and months)?
 

Rental Information (if applicable)

Dogs permitted Yes No
Number of dogs permitted
Weight limit (list in lbs.)
Landlord Name
Landlord Address
Landlord Phone Number
*GOBR, Inc. requires a copy of Landlord Statement/Lease Agreement for renters.
 

Previous Residence(s)

Previous Address
How long did you live at this address?
Do you have plans to move within the next year? Yes | No
If you have plans to move, please explain
Even if you do not have plans at this time for moving in the future, what considerations would you make regarding your dog(s) and other pets should you find yourself needing to move from where you now live?
 

Neighborhood and Fences

Do you have a fenced yard Yes No
What type of fence do you have? Chain Link | Privacy | Other
Do you have a kennel/run Yes No
Dimensions of fenced yard or kennel run
If no fence / kennel run, how will exercise/toilet be handled?
Do your neighbors have pets? (This includes people next door across the street, and in your immediate surroundings such as your block) Yes No
If your neighbors do have pets, please provide information as to type including whether it is a cat or dog, breed, size, temperament, if it is an outside or inside dog, etc.
What are the requirements of dog ownership in your community? (i.e. licensing, rabies, leash laws, and number of dogs you may legally have)
 

Other Animals

How many of each type of pet are currently in your home? Dog(s) | Cat(s) | Bird(s) | Rabbit(s) | Other
Please list all pets currently owned
If your dog(s) or cat(s) are NOT altered (spayed/neutered), please explain why
Do you own livestock? Yes No
List type, sex and age
How is each type of livestock kept?
Have all other pets/livestock been around dogs, particularly medium to large dogs such as a Boxer?
Are all pets/livestock current on immunizations and on preventative care?
If pets/livestock are NOT up to day, please explain
 

Veterinarian Information

Who is your current veterinarian?
Current Vet Address
Current Vet Phone
Name, phone number, city and state of any other veterinarians you have used
Please list the name, phone number, e-mail address, web page of any groomer, pet sitters, boarding kennels or dog trainers you use currently or have used in the past.
 

Previous Animals

How many dogs have you owned in the last 5 years?
If so, what breeds of other dogs?
What happened to these dogs?
If you've ever had to give a dog away, please give the details of the circumstances, and provide the name and address of the person to whom the dog now belongs
Have you owned a Boxer before?
If you no longer have it, what happened to it/them?
 

Boxer Preferences

Why do you want to adopt a RESCUE Boxer?
Plans for this Rescued Boxer?
If you chose other, please explain
Breed Preference
Sex Preference
Color Preference
Age Preference
Is there a color you would not want and why?
Do you have a strong preference about the dog's tail or ears?
If so, what and please try to explain why you feel this way.
Would you consider adopting a dog with a disability, such as a 3 legged dog or one with only one eye?
Would you consider adopting more than one dog?
Would you consider adopting a "senior" dog?
What is the oldest dog you would consider adopting and why?
 

Day to Day

Where will dog spend most of each day?
Where will dog sleep?
How many hours will dog be alone each day?
Who will be in charge of the daily care of the dog?
List your life activities in which you would enjoy including your dog
What arrangements would you make for dog when you are away from home for an extended period, such as a vacation or business trip?
What kind of dog food do you currently, or plan, to use? Give brand name if commercial dog food please.
What feeding schedule do you plan to use?
 

Discipline, etc.

Will dog be allowed on your furniture?
What is your definition of disciplining a dog? Please provide examples
List the types of behavior problems you consider NOT acceptable
What type of discipline have you found effective when your dog has been destructive or misbehaved?
What will you do if your dog is destructive while left alone?
What is your opinion on formal obedience training classes?
Are you willing to attend obedience classes with your dog?
Please explain your thoughts on house training
Please explain your thoughts on crate training
Do you own a crate?
Even if you have never experienced the use of a crate with a dog in the past would you be willing to use one if the dog that you and GOBR feels is best suited to your home needs one?
If not, why?
In what situations do you feel physical discipline might be effective? If any, what type of physical discipline?
If approved and you adopted a Boxer from us, what measures would you take if your rescue dog had behavioral issues that you could not correct?
What circumstances, in your mind, justify getting rid of a dog? Please be specific.
At what point would you consider euthanasia should your dog become ill?
 

Other information

List any Humane Societies, Organizations, Breed or Training Clubs you are associated with and give some contact info such as web page or e-mail address
Have you applied to adopt from, or volunteer with, any other rescue organization in the last two years?
Are you currently working with any other rescue organization?
If yes to either of the above please list the name of the organization and give a contact person's name and contact information for them.
Additional comments and/or information that you think might help us find the right Boxer for you, including more about your preferences and reasons for wanting a Boxer
How did you hear about GOBR?
Is there a particular Boxer on our Petfinder.com site that you are interested in?
Boxers available from GOBR, Inc. are located in foster homes throughout the state of Ohio. Prospective families are often asked to visit the dog while he or she is in Foster Care to ensure that the dog is in a natural, relaxed, non-stressed setting.

An inability to do this will *not* preclude you from being able to adopt from GOBR but it may make other applicants, who apply after you and are willing to drive, more likely candidates for a specific dog.

How do you feel about driving to see a foster dog? Would you be able to drive to meet a dog?

We have volunteering opportunities throughout the state of Ohio. Are you interested in Volunteering with GOBR?
If so, in what way would you like to help?
 

Do you agree to the following?

Spay/Neuter within 30 days if dog is not already altered?
Administer Heartworm medication monthly and get yearly Heartworm checks?
Keep current license and ID tags on dog at all times?
Provide timely health care for dog?
Restrain dog in open vehicle, i.e. pickup truck or convertible?
Return dog immediately to GOBR if you can no longer keep or care for dog?
Allow GOBR agent to visit your home prior to or after adoption?
 

Signature Agreement

A) I agree by initialing this line that typing my name in is the same as signing my name to this legal document. (Applicant's initials)
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)
 

Financial and Physical verification

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)
 

Application Truthfulness

I understand that if the information contained herein is in any way 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)
Have you or any member of your household ever been convicted of animal cruelty? Yes No
Are there pending animal cruelty charges against you or members of your household? Yes No
I have listed only NON-Relatives as references, and they do not live in my home, as stated in the directions Yes No
 

Adoption Fee Statement

I understand that the adoption fee is nonrefundable. (Applicant's initials)
 

Permission To Investigate

By submitting this application to GO Boxer Rescue, Inc I grant my permission to investigate my answers and to contact anyone I have listed. I further acknowledge that I have read and understand the Privacy Policy posted on the GOBR website. (Applicant's initials)
I understand that in order for my application to be considered I MUST answer ALL questions. I have reviewed my application and have answered all questions. Yes No
 

Application Completion

Signature
Email Address
Date
 

Please print this page for your records before submitting it!

Revised October, 2004 GOBR