 |
Cedar Valley Boxer Rescue Temporary Evaluation Home Application |
No.__________ |
Name:
_______________________________________________________________Date:
_______________________
Address:
_________________________________________________________________________________________
City:
______________________________________________State: _______________________
Zip: ______________
Phone (home, work,
Cell): _____________________________________ email:
_________________________________
Date you could accept
a Rescue Dog: ________________ Number of dogs you can accept at one time:
______________
List any limitations
you may have with accepting a Rescue Dog:
_____________________________________________
________________________________________________________________________________________________
1) Are you a member of Cedar Valley
Boxer Club? _______________________ If so how long? ___________________
2) If your are not a member, would you
like to be? _______________________________________________________
3) Who from the club will be your
sponsor? _____________________________________________________________
4) Why do you want to be a temporary
home evaluator? _________________________________________________
___________________________________________________________________________________________
6) What kind of experience or knowledge
do you have with Boxers? _________________________________________
7) What kind of experience or
knowledge do you have with rescue? _________________________________________
8) Would you be willing to temporarily
keep a Boxer that requires special care due to physical handicaps or special
medical care?
_________________________________________________________________________________
9) Would you be willing to temporarily
keep a Boxer that requires extra time and patience to overcome some training or
minor behavior problems?
________________________________________________________________________
10) What are your views on training and working
with behavioral problems? ____________________________________
11) Are you aware of the responsibility and commitment
a rescue dog will demand? ______________________________
12) Are you able and willing to accept some of the
financial burden of caring for a rescue Boxer? ___________________
13) What
is the name of your vet? _____________________________________________________________________
14) How many people are in your household?
______________ Ages? ________________________________________
15) Are there other
Boxers or pets in your home? __________________If so list what age & sex:
___________________
_____________________________________________________________________________________________
16) Will someone always be home to attend to the
rescue dog? _____________________________________________
if not, how long would they be alone? _______________________________________________________________
17) Where will the rescue dog be kept?
_________________________________________________________________
18) Do you have a fenced yard or kennel run?
___________________________________________________________
19) Do you plan on
crating the rescue dog?
_____________________________________________________________
20) Can you accept a
dog that cannot be crated?
_________________________________________________________
21) Do you have the necessary supplies to care for
a rescue dog? ___________________________________________
22) What food do you plan to feed?
____________________________________________________________________
23) What other information or supplies would you
need to accommodate a rescue dog? ___________________________
24) Do you have any questions regarding being a rescue dog evaluator? ________________________________________
25) Would you be interested in helping in other Boxer rescue activities? ________________________________________
Other comments: ___________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
____________________________________________________________________________________________