7.5.4.4.0
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The FBR Application to Adopt, Foster or Volunteer

1. General Questions

By clicking yes, you are stating that you live within one of the counties listed above. * Please make a selection.
Select the position you'd like to be considered for *


Adoption Foster Home Volunteer

Note: Foster Home means providing evaluation and temporary care
to a dog who needs to live in a home environment prior to adoption.
Minimum number of selections of 1 not met.Maximum number of selections exceeded.
Describe the physical attributes of the Boxer you want to adopt * A value is required.
Describe what type of personality traits you are looking for in a Boxer * A value is required.
Gender * Color/Markings * Age * Ears *  
Please select an item. A value is required. A value is required. Please select an item.  

2. You and your household
Your Name: First Name:* A value is required. Last Name:* A value is required.
Your spouse, room mate or partner: First Name: Last Name:
Address* A value is required. Address 2 City*
A value is required.		 State*
A value is required.		 Zip Code*
A 5 digit value is required.A 5 digit value is required.
Occupation* A value is required. Primary Phone*

xxx-xxx-xxxx Value needs dash format.Value needs dash format.		 Work Phone

xxx-xxx-xxxx Value needs dash format.		 County* Please select an item. Email Address* A email is required.A proper email is required.
Has your spouse, roommate or partner agreed to adopt a dog?
* Please select an item		 Is anyone in your household allergic to pets? Please make a selection.
List the ages of all children in your house*
A value is required.
 Why bring a Boxer into your household?*
A value is required.		  
Why is a Boxer the right breed for you?*
A value is required.		 How did you educate yourself on boxers?*
A value is required.		  
* Have you ever been arrested, charged or convicted of animal abuse, neglect or endangerment?
Please make a selection.
If yes, please explain the circumstances

3. Your house and property
What is your housing situation?
* Please select an item.

If other, please explain:


If you live in a condo, townhouse, or other development with a Home Owners Association, list the name, address and phone number of property manager or HOA Officer. If none, type "not applicable." 		* Are you in Military Housing?
Please make a selection.
Do you own or rent? If you rent, you must input your landlord's contact info below or your application will not processed.*
Please make a selection.
Landord's Information
First

Last

Address 1

Address 2

Phone xxx-xxx-xxxx

City

State

Zip
Do you own a swimming pool? * Please make a selection. Is the swimming pool enclosed?
Is your yard fenced in? * Please make a selection. What is the height and type of the fence?

4. About Your Pets & Estimated Expenses
Cats: Are there cats in your household? *
Please make a selection.
Dogs: Are there other dogs in your household? * Please make a selection.

If yes, please list each dog's breed, gender, age, current status of vaccinations and status of spaying or neutering A value is required.		 Please list/describe any other pets or livestock you currently own. * A value is required.
Please list the names of all your pets*
A value is required.
Other than the pets listed above, have you had dogs in the past? *

Please make a selection.
If yes, what happened to them? A value is required.		 FBR will call to verify your veterinary reference. If you do not currently have any pets, please provide the name of the veterinarian you used in the past.
Veterinarian's Information: *

Vet's Name: * A value is required.

Clinic Name: * A value is required.

Vet's Phone: * Value needs dash format.Value needs dash format.   xxx-xxx-xxxx
Provisions & Estimated Expenses for Your Boxer
The owner of a Boxer should expect to make regular vet visits as well as have some money put aside for emergency health concerns.
Please describe your daily routine * A value is required. How many hours will your dog be left alone? * A value is required.
Where will your dog stay when you are at work or away from home? *
A value is required.
Where will the dog sleep? *
A value is required.		 Who will be primarily responsible for the dog? *
A value is required.
What will happen to the dog if you move? *
A value is required.		 Under what circumstances would you not keep a dog? (Select all that apply) * Other Moving New Baby Divorce Illness Minimum number of selections of 1 not met.Maximum number of selections exceeded.

Please explain: * A value is required.
Are you willing to go through obedience training with your Boxer? *
Please make a selection.
What is your philosophy regarding discipline of your dog? * A value is required.
How do you plan to handle potty accidents in your home? * A value is required. Will you take responsibility for the dog's entire life(upwards of 10-12 years)?*
Please make a selection.
What arrangements have you made for your pet in the event of an emergency or death? *
Please select an item.
If other, please explain:  
Please estimate how much you plan to spend per year on this dog's medical care: * $ A value is required.
Estimate how much you expect to spend on FOOD and other NON-MEDICAL EXPENSES per year: * $ A value is required.
List the health concerns you are aware of in the Boxer breed: * A value is required.
Are you willing to pay for any medications your Boxer may need in the future?* Please make a selection

5. Miscellaneous Questions
May an FBR representative come to your home and visit with you? Please note: If you are outside FBR's service area, you will need to apply with and be approved by your local Boxer rescue before adopting from FBR. We do not have volunteers outside our service area, and therefore, cannot conduct your home visit if you are outside our service area.
Please make a selection
Have you applied to or are you working with any other animal rescue or adoption organizations? * Please make a selection.
Please list the name(s) of the rescue(s) you have applied to:
How did you hear about FBR? *
Please select an item.
If other, please explain
Do you agree to return the Boxer to FBR, Inc. if you decide you cannot
keep him or her? *
Please make a selection.
Would you be willing to foster or adopt a special needs dog? * Please select an item.
Additional Comments:
 If you wish to include additional information, please do so here.
Please write your full name to verify your online signature: * A value is required.
Please do NOT click the Submit button more than once. After clicking submit there is a normal delay in processing the form.