WHITE BOXER RESCUE
Connie & Dan Domeracki, PO Box 734, North Cape May, NJ 08204
(609) 889-7629
[email protected]
FAX: (240) 465-8134

Date-

Name-

Address-

State-

Zip Code-

Phone-

Donation-

Places of employment with Phone Numbers-

Work Schedules-

Type of home (apt., single family, ect.)-

Do you own home, rent-

Are you planning on moving within the next year?-

How many people live in you home?-

Do you have a dog or dogs now?-

How many?-

Breed/breeds? Ages? Names? Genders?-

Or have you owned dogs in the last 5 years?-

What breed(s)?-

What happened to your last dog?-

Do you own or house any other animals?-

List species and number?-

Are your current pets spayed or neutered?-

Your Veterinarian, present or past"-

Address and phone number?-

Do you have a fenced yard?-

If yes what size?-

If no are you planning to?-

How do you plan to exercise a dog?-

Do you have a dog crate?-

If yes what size?-

How long would the dog be kept in the crate daily, if at all?-

Do you have outside kennels?-

Do you belong to any training or kennel clubs?-

Would you adopt a dog with a treatable health condition?-

Would you consider a special needs dog? (daily meds, deaf, etc.)-

Would you adopt a dog with a disability? (amputee, heart condition, etc.)?-

Who will care for your pet during vacations?-

What will you do if your dog is destructive while left alone?-

What is your definition of disciplining a dog?-

Are you now or have you been, in the past, a breeder? Please explain-

List two references (No more than one relation.) #1-

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List two references #2-

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Do you have any children?-

If yes, how many?-

Please explain why you are interested in a boxer.-

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What age boxer are you interested in?-

Would you consider another age?-

Male or female?-

Color?-

What are your preferences for a dog if any, such as doesn't get on furniture, must like cats, good with children and so on....

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AFTER EVALUATION OF YOUR COMPLETED APPLICATION, IF RESCUE IS CONSIDERING
YOU FOR AN ADOPTION, RESCUE WILL CONTACT YOU TO SCHEDULE A PROPERTY
INSPECTION. IF YOU ARE APPROVED AND LIVE MORE THAN 100 MILES FROM RESCUE, THERE WILL BE A TRAVEL CHARGE OF $50.00. SPECIAL TRAVELING ARRANGEMENTS AND FARTHER DISTANCES WILL BE NEGOTIATED. THANK YOU FOR YOUR INTEREST IN WHITE BOXER RESCUE

CONNIE AND DAN DOMERACKI