The information requested in this form will assist us in matching you to the right dog for your family, needs and lifestyle.  We take this responsibility seriously and will not adopt out to any home
when we cannot feel totally confident of the adopters willingness and ability (financial and personal) to commit to a Boxers future well-being and happiness.

An adoption fee is required at the time of the signing of the contract.  This fee is non refundable for any reason.  Throughout the life of the Boxer, if any reason should arise where you are unable to keep the dog, we require that you notify our rescue of the availability of him/her and to return the adopted pet upon request.  We strongly recommend that this puppy be micro chipped for safety.  Please
realize that you are not at liberty to dispose of this puppy in any way, except to return her/him to us. The dog may not be sold, given away, put in a shelter or euthanized without the knowledge and permission of rescue.


We also strongly recommend that you take your new dog to the vet within the 1st 2 weeks of adoption so that your vet has all his/her information on file.

This Application is the first step in a process that we anticipate will culminate in the placement of a healthy and temperamentally sound Boxer into your home as a new family member.
Understand that PA Boxers Inc, or property where adoptions are held is not responsible for anything that takes place or is adopted from their property and should not be contacted in any case. The rescue holds the responsibility of what is adopted out.

Adopt fee is $300 for a Boxer up to 8 years old and $150 for a Boxer 8 years and older. . Adoption fee will be collected at the time of delivery of your dog.
Cash (please ask for a receipt!), Checks (made to PA Boxers Inc ONLY) and online PayPal with a credit card are accepted. 

No information offered on this form by you will be given to third parties for any purpose.
We reserve the right to refuse adoption to anyone, for any reason, at any time.

EVERY QUESTION MUST BE ANSWERED OR FILLED IN WITH AT LEAST N/A IF IT DOES NOT APPLY TO YOU.  

Initial to indicate you have read this page._____________


Name_____________________________________________________________________                       
Address__________________________________________________________
City, State, Zip Code_____________________________________
E-Mail Address________________________________________
Best phone number to contact you:______________________________________________
Do you own your home?   Yes________  No ________
Do you have a fenced in yard and how tall is it?________________________________________
If no fence how will your pet receive exercise? _______________________________________
Please describe the type of Boxer you are looking for. (age, sex, breed mix) Name:_______________
___________________________________________________________
The Boxer may not be housebroken...Are you willing to take the time to work with this type of
training?___________________________________

How much do you think the yearly cost of owning a dog will be? (Including food, bones, toys, vaccinations, medications, emergencies
etc...)___________________________
Where do you work?_______________________________________________________
Does the primary adult caregiver work outside the home? Hours you work:__________________
Will you crate and how many hours a day will the puppy be crated each day? (Not including sleeping hours overnight)
_________________________________________________________
Are you over 18? YES__________NO__________
Number of persons in your household _______
Ages of everyone in the home:____________________________________________________
What issues are you NOT willing to deal with in an adopted dog?_________________________
Are any members of your household allergic to animals?_______________________________
Other animals in the household________________________________
Are all dog(s), cat(s) spayed/neutered, and current on vaccines?_________________________________
What happened to the pets you no longer own?  ______________________________________
What do you consider a valid reason for giving up a dog or pet?_________________________________
____________________________________________________________
Are you prepared to commit to a pet for 10-15 years (average life span)? YES _____ NO___________
Are you willing to allow our rescue to make announced visits to your home?  __________
Do you agree that if you become unable to keep your pet for any reason, it will be returned to our rescue?  YES_______NO_________
What kind of dog food do you plan to feed your puppy?(please do not answer: puppy feed or dog food)
__________________________________________________________________________
Who is your Veterinarian/what is there phone number?  
______________________________________________________________________________
Please provide name/address/phone # of a neighbor who can confirm fencing and prior/current pet ownership and 2 or 3 references
that can testify to your responsibility and ability to care for your animals.   Please place their names and phone numbers below:
______________________________________________________________


I understand that the rescue has given vaccines and I will receive paperwork on all vetting that has been done. I understand this is a living creature and I will care for my new dog.

I hereby certify that the above information is correct to the best of my knowledge and you thoroughly read the opening adopt page.

Date  ______________________ Signature   _________________________________
Date  ______________________ Signature   _________________________________
Please return via email or fax to 215-525-6222

Thank you!
PABoxers, Inc

PO Box 826

Lancaster PA 17608-0826
PABoxers@Gmail.com
Phone 717-397-9377
Fax 215-525-6222
www.PABoxers.com