Name:      

Address:      

City:      State:      Zip:

Email:    

Home Phone:         Cell Phone:

Best time and place to reach you:      

Occupation:      

Employer:      How long at current Job:

Spouse/Significant Other's Name:      Occupation:

Employer:      How long at current Job:

Names and ages:

How many children in your home:      Ages:

If children are present in the home, have they ever been exposed to dogs before?     Yes No N/A

Personal References (not related to you please):

1)  Name:      Address:

     Home Phone:      Relationship to applicant:

     Years Acquainted:

2)  Name:      Address:

     Home Phone:      Relationship to applicant:

     Years Acquainted:

3)  Name:      Address:

     Home Phone:      Relationship to applicant:

     Years Acquainted:

Name, phone number and Address of your current veterinarian. If you do not have any pets currently, but did, please provide previous veterinarian information.

Description of your Home:

1. What kind of home do you live in?

      Single Family Home Apartment Trailer Townhouse/Condo

2. Do you:

      Own Home Rent Live With Parents/Relative

3.  If you rent, please provide the name, address, and phone number of the Landlord:

4.  How long at your current address: Years   Months

5. Do you have a fenced in yard?         Yes No Partial

6.  If Yes or partial fencing, please provide approximate measurements, height and type of fencing:

7. Do you have a Kennel Run?         Yes No

8. If Yes, please provide approximate measurements of your kennel run:

9. If No, how will dog be exercise & toilet be handled:

10. Which best describes your home?

      House in the Country House in the City House in the Suburbs House in a Rural Area

11. Is there anyone in your home with animal related allergies-If so please explain: 

Pets in Foster Home: 

1. Do you presently own any dogs?       Yes No

2. If yes, are they spayed or neutered?     Yes No

3. Other pets in home?      Yes No

4.  List names, breed and gender of each of your current pets (cats, dogs, etc.):

     Pet #1      Pet #2

     Pet #3      Pet #4

     Pet #5      Pet #6

5. How many other dogs have you owned in the last 5 years?      0 1 2 3 4 5+

6. What happened to your last dog?     Lost Stolen Given Away Other-See Below N/A

     Died-list age and cause:

     Other-please explain:

7. Are all of your animals (dogs/cats) on heartworm preventative and flea and tick control?    Yes No N/A

Living Environment:

1. Where will your foster dog spend most of the day? Indoors Outdoors

2.  If Indoors: Crate Basement Garage Free run of the house Limited area of house

3.  If Outdoors: Fenced Yard Tethered Kennel Outside Shelter N/A

4.  How many hours will the foster dog be alone each day:

5.  Is someone home at all times or will the dog need to be alone for a portion of the day: 

6.  Where will the foster dog sleep? Crate Dog Bed Family Member's Bed Basement Garage

Exercise and Discipline:

1.  How would you exercise your foster dog:

     Fenced area attached to home-please explain:

     Walks on leash-please explain:

     Other-please explain:

2. Have you ever house trained a dog ? Yes No

     If yes, please describe your method used to house train:

3.  What is your definition of disciplining a dog:

4.  How would you handle a dog's destructive behavior? For example, dog gets into garbage, chews, etc:

5. Have you or your family ever owned a Boxer?    Yes No

6. Why do you want to foster a Boxer? 

7. Further comments or additional information that you would like us know:

8. Do you agree to allow a Boxer Rescue agent to visit your home prior to fostering? Yes No

9. Please let us know how you heard of our organization? Internet Search Engine Petfinder.com Friend/Family Member Boxer Expo Day - BAR Representative Other Shelter/Rescue Organization Met Former Adopter