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ONLINE ADOPTION APPLICATION

Boxer Rescue LA carefully screens each potential adopter to find the right home for each of our Boxers. Every Boxer has a different personality, traits and needs, so we carefully screen to make sure that we make a good match and this will be a permanent home for the Boxer.

ALL fields with * are REQUIRED or form won't process!
PLEASE ONLY SUBMIT FORM ONCE! Thank you ...

After submitting your application, you will be contacted by BRLA via email.

 
* Your Name
* Street Address
* City/State/Zip
* E-Mail Address
* Phone # * Work # * Occupation
* Personal Reference
* Reference Phone # * How Many Years Acquainted?
* Do you live in:   House   Apartment   Condo   Other
If Other, please explain:
* Do you own, rent or lease your home?   Own   Rent   Lease
* How tall is your fence?   8 Foot   6 Foot   4 Foot   No Fence
* Lowest point on the fence?  8 Foot  6 Foot  4 Foot  No Fence
* How many live in adults? * Do you have children?   Yes   No
If children, please specify how many and their ages:
* Do you currently have any other dogs?   Yes   No
If yes: Breed[s]   Sex   Age[s]
* Are all your animals spayed or neutered?   Yes   No
If no, please explain why not:
* Do you have cats, other pets or livestock?   Yes   No
If yes, please list them here:
* Your Veterinarian * Vet's Phone #
* How many dogs have you owned in the last 5 years?
* What happened to the other dog[s]?
* Have you ever owned a Boxer?   Yes   No
* What do you like about Boxers?
* Why do you want to adopt a Boxer?   Pet   Guard Dog  Both
* Would you prefer ...   Fawn   Brindle   White   No Preference
* What age group best fits your family and lifestyle?
1-2 Years   2-5 Years   5+ Years   No Preference
* Where will your Boxer spend most of the day?
If Other, please explain in detail:
* Where will your Boxer sleep at night?
If Other, please explain in detail:
* How many hours will your Boxer be left alone each day?
* How will your Boxer get exercise?
* Will you keep your Boxer's license current?   Yes   No
* Will you provide healthcare in a timely manner?   Yes   No
* Will you return your Boxer to BRLA if you can no longer care for it?
Yes   No
* Will you allow a Boxer Rescue LA representative to visit your home?
Yes   No
Additional Comments:
* How did you find out about BRLA?
If Other, please explain how you heard about us:
* Electronic Signature
Your electronic signature below serves as acknowledgement that this is a sincere inquiry, and that all information provided is true, correct and complete. On the Internet an Electronic Signature carries the same legal weight as if you were signing your name to a printed document. To complete this form, please provide your electronic signature below by typing your name in the box, then submit the form.
    

PLEASE ONLY SUBMIT FORM ONCE! Thank you ...

Copyright 2005, Boxer Rescue L.A. All Rights Reserved.
Email: webmaster@boxer-rescue-la.com