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ADOPTION APPLICATION
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CBR FEATURED DOG
BUBBA/LUCCI
Adopt a Boxer from CBR of Florida
The information that you provide in this application aides Coastal Boxer Rescue in determining which of our boxers best fits your personality and lifestyle. Please fill out our application form located below. Make sure to answer all questions. Incomplete forms may not be processed. You will receive a confirmation e-mail that your form was received. Volunteers try their best to process applications within 10 days time. Please be patient. This is strictly a volunteer organization. Please note: You must be 21 or older to be considered as an adoptee. Adoption Fees: The following rate structure helps us cover the costs that we incur here at CBR. Your adoption fee is applied directly to our vet bills and pays for the Boxer's sterilization, fecal, exam, vaccines, microchip (if applicable), and general care while in the adoption program. None of the volunteers are paid. Even though the adoption fees help offset our medical bills, we still depend on donations from the public. Thank You from all of us here at Coastal Boxer Rescue of Florida. 8 weeks-6 months 6mo.-2 yr. 2 year-6 yr. Over 6 yrs. $To be Determined $275.00 $260.00 $175.00 You will either be contacted by e-mail or telephone in regards to the status of your application. Please monitor telephone messages and your e-mail. If you e-mail our organization to inquire about adoption or your application's status please remember to include your full name and telephone number with area code for a timely response. Please use this address for inquiries: info@coastalboxers.org Home visits are scheduled prior to adoption as part of our adoption process. Not everyone who applies is able to adopt from Coastal Boxer Rescue of Fla. Our mission is to find homes best suited for this often misunderstood breed.
Fields marked with an (*) are required
YOUR INFORMATION
First Name*:
Last Name*:
Address*:
City*:
Home Phone*:
Work/Cell Phone :
ZIP*:
State*:
FL
AL
AK
AZ
AR
CA
CO
CT
DE
DC
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Closest County*:
Brevard
Broward
Dade
Flagler
Indian River
Martin
Palm Beach
St. Lucie
Volusia
Email*:
Best Time to Call*:
REFERENCE
(other than a family member)
Name*:
Email*:
Address*:
City*:
Relationship*:
Phone*:
Zip*:
State*:
FL
AL
AK
AZ
AR
CA
CO
CT
DE
DC
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
ADOPTION INQUIRY
Why have you chosen to adopt a Boxer?*
Do you prefer a Male or Female?*
No Preference
Male
Female
Where will your new boxer stay during the day?*
Not Applicable
Inside, Free to roam house
Inside, Crated
Outside, Fenced yard
Outside, Dog run
Garage
Where will your new boxer sleep at night?*
Not Applicable
Inside, In our bed
Inside, Crated
Outside, Fenced yard
Outside, Dog run
Garage
How many hours on avg will your dog be alone?*
Who will care for your pet(s) when you're on vacation?*
Do you have an age preference?
No Preference
Under 1
2-3
4-5
6-7
8
Older
Is there a specific Boxer on this site you're interested in?
BOXER BREED UNDERSTANDING
(check all that apply)
Have you done any research on the Boxer Breed?*
yes
no
I have owned a Boxer
Have done research on the internet
I have read books on the Boxer breed
Other, please describe:
I have a friend &/or family member who owns a Boxer
YOUR PETS
(past & present)
How many
DOGS
do you currently own?*
0
1
2
3
4
Describe what happened to the pets you no longer own:
How many pets have you owned in the past 5* years?
0
1
2
3
4
5
6
Please list current Dogs
DOG 1
Sex:
Not Applicable
Male
Female
Name&Breed:
Age:
Altered:
N/A
Yes
No
DOG 2
Sex:
Not Applicable
Male
Female
Name&Breed:
Age:
Altered:
N/A
Yes
No
DOG 3
Sex:
Not Applicable
Male
Female
Name&Breed:
Age:
Altered:
N/A
Yes
No
Where do your dogs stay during the day?
Not Applicable
Inside, Free to roam house
Inside, Crated
Inside/Outside w/doggie door
Outside, Fenced yard
Outside, Dog run
Garage
Where do your current dogs sleep at night?
Not Applicable
Inside, in our bed
Inside, Crated
Outside, fenced yard
Outside, dog run
Garage
If you currently own more than three dogs please enter their information here
Please list current Cats
CAT 1
Sex:
Not Applicable
Male
Female
Declawed:
N/A
Yes
No
Age:
Altered:
N/A
Yes
No
CAT 2
Sex:
Not Applicable
Male
Female
Declawed:
N/A
Yes
No
Age:
Altered:
N/A
Yes
No
CAT 3
Sex:
Not Applicable
Male
Female
Declawed:
N/A
Yes
No
Age:
Altered:
N/A
Yes
No
Does your cat(s) stay indoor or outdoors?
Not Applicable
Indoors Only
Outdoors Only
Indoor/Outdoor
If you currently own more than three cats please enter their information here
VETERINARIAN INFORMATION
Name*:
Phone*:
If no please explain:
Is this the vet you currently use?*
N/A
Yes
No
YOUR RESIDENCE INFORMATION
Do you currently Rent or Own your home?*
Own
Rent
Landlord Name:
(if applicable)
If you rent, do you have your landlord's permission to keep a dog?
N/A
Yes
No
Landlord Phone:
Please specify type of residence*
Single Family Home
Apartment
Townhouse/Condo
Duplex
Mobile Home
Other
If other please describe:
How long have you lived at this address?*
Do you have any plans to move in the immediate future?*
N/A
Yes
No
Do you have a fenced yard?*
N/A
Yes
No
If yes, what kind of fence do you have? (select all that apply by holding down control+left-click)
N/A
4 Foot
5 Foot
6 Foot
7 Foot
8 Foot
Chain Link
Privacy
Invisible/Electronic
Other
OCCUPANTS
How many adults in your household?*
How many children (under18) in your household?*
Please list the ages of all the children under 18
Are you willing to go through obedience training with your Boxer?*
N/A
Yes
No
Is everyone in your household agreeable to adoption?*
Yes
No
How did you hear about Coastal Boxer Rescue?*
*By checking this box,
I verify that I'm over the age of 21 and understand that CBR's priority is to serve the best interests of the Boxers in its care. Therefore we will request a home visit to verify living conditions. CBR also reserves the right and sole discretion to refuse an adoption to anyone for any reason.*
Type your full name and date on these lines to signify your signature*
Before clicking 'Submit' make sure everything has been filled out completely. Place an "n/a" where applicable.
FAVORITE LINKS
Canine Influenza
American Kennel Club
Florida Boxer
Rescue
B.A.R.C.
BoxerRescue Foundation
American Boxer Rescue
Blue Ridge Rescue
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