First Name*
Last Name*
Address
City
State/Province
Zip/Postal Code -
Email*
Home Phone
Cell Phone
Name of Applicant:*
Name of Spouse:*
Children/Ages: (If Applicable)
List the names and ages of other residents in the home: (If Applicable)
Address:*
Environment Type:
Home Type:
Privacy Chain Link Invisible other Choose all that apply: Yes No
What is the size of the yard?*
Is there a fence surrounding all or part of the yard? Full partial
Type of fence:
Was the fencing and yard adequate for current and/or future pets?* Choose one: Yes No
If no, please explain.
Does the gate have a lock? Choose one: Yes No
Do they currently have a dog run/dog house?
Please describe any safety or health concerns in the yard.*
Please describe any safety or health concerns in the home.*
Describe where their dog will be kept most of the time?*
Do they have other pets? * Choose one: Yes No
If yes, please list type, breed, age and sex.
Do their current pets look healthy and well cared for? Choose one: Yes No Not Applicable
Did their pets act appropriate towards you? Choose one: Yes No
Did their pets act appropriate toward the children? Choose all that apply: Yes No Not Applicable
Did they discipline their animals in your presence? Choose one: Yes No
If so, was it done in an appropriate manner? Choose one: Yes No
Were the children well behaved? (If Applicable) Choose one: Yes No
Did the children have appropriate behavior when interacting with the existing animals? Choose one: Yes No
Does the adoption application information match up to the physical home check?* Choose one: Yes No
How does the resident dog(s) react when around other dogs?*
Discuss that the rescue will do it best to provide information on temperament and behavior but a foster or adopter must understand that a pet is an individual animal with its own mind; there are inherent risks with the guardianship of any animal and there is no expressed or implied temperament guarantee. As a Foster or Adopter, they agree to be fully responsible for the pet until it is safely returned to MNBR, adopted, or passes away. If any unmanageable condition or issue arises or is discovered, they shall immediately notify and safely return the animal to MNBR. Choose one: Yes No
I understand that ANY veterinary visits or expenses the rescue has agreed to cover (or is to cover in foster instances) must be pre-approved, noted in the adoption contract, done by one of the rescues approved veterinarians, and paid for by the rescue. Expenses incurred without approval, not noted in the adoption contract, or paid by any party other than the rescue without approval will not be reimbursed. Emergency visits for fosters are the exception. * Choose one: Yes No
I understand that ANY veterinary visits or expenses the rescue has agreed to cover (or is to cover in foster instances) must be pre-approved, noted in the adoption contract, done by one of the rescues approved veterinarians, and paid for by the rescue. Expenses incurred without approval, not noted in the adoption contract, or paid by any party other than the rescue without approval will not be reimbursed. Emergency visits for fosters are the exception.
Would you entrust an animal of yours to their care?* Choose one: Yes No
Please explain why this applicant should or should not b approved to adopt.*
Name of HV Committee Member:*
Date of Evaluation: *
Minnesota Boxer Rescue
Bringing a Boxer into your home and your life is a major decision.It brings with it responsibility and commitment, but it also renders supreme joy, laughter, and sadly but inevitably, tears.No one of us who has ever shared his life with a Boxer would have it any other way.
PO Box 25773 Woodbury, MN 55125763.647.3037
501(c)(3) EIN# 20-4758118