SOUTH TEXAS BOSTON TERRIER ADOPTION APPLICATION

Applicant Personal Information Name:

First and Last

Telephone:

Best time to contact by phone or text?

Address:

City:

State:

Zipcode:

Email:

Date of Birth:

TDL#:

Employer:

Occupation:

Spouse’s Name:

Telephone:

Email:

Date of Birth:

TDL#:

Employer:

Occupation:

Applicant understands that by submitting this adoption application, you agree to reference checks, both personal and with the veterinarian listed. Please make certain to contact your vet’s office and give authorization to release information to STBTR. By signing below, you understand that if you are approved for adoption, you agree to: Keep the dog current on vaccinations, heartworm preventative and regular annual veterinary care. Transfer Microchip Registration with your contact information Provide a climate controlled indoor home. Provide adequate quality food and fresh water daily. Return dog to South Texas Boston Terrier Rescue if for any reason you are unable to keep. Adoption fee may or may not be refundable and is at the sole discretion of South Texas Boston Terrier Rescue. Signature:

Date:

Signature:

Date:

Type of Housing:

Single Family
Apartment
Townhome
Acerage
Other

Do you:

Own
Rent
Lease
Other

Do You Have A Fenced in Yard?

Yes
No

Do You Have A Pool?

Yes
No

Family How Many Adults in Your Household?

Please List Their Name(s), Age(s), And Relationship(s).

{name}

How Many Children in Your Household?

Please List Their Name(s) And Age(s):

{name}

Is Everyone In The Household Aware Of A Pending Adoption?

Other Household Pets Please List Their Name, Age, Breed, Sex, And If Altered (Y/N)

{name}

Are All Current Pets Up To Date on Vaccinations/Heartworm Preventative?

Please submit proof of current vaccinations/heartworm test with your application if available.

Attach file

Drop files here

What Brand of Heartworm Preventative Are They Currently On?

Veterinarian Name & Telephone:

Please add the pets names that are patients at the clinic and the name of the account holder.

{name}

Additional Information Have You Ever Surrendered or Rehomed a Pet?

Yes
No

Where Will The Dog Spend The Day?

Where Will The Dog Spend The Night?

Number of Hours Dog Will Be Alone:

Do You Crate Your Dog?

Method of Discipline:

Who Cares For Pets When Away from Home, Vacations, Etc.:

Do you have a preference in age, sex, personality, etc.? Please describe the best fit for your family:

Which pet are you applying for?

Add

Personal References Familiar With You and Your Pets Name:

Address:

Phone:

Relationship:

Years Known:

Name:

Address:

Phone:

Relationship:

Years Known:

Name:

Address:

Phone:

Relationship:

Years Known:

Where Did You Hear About STBTR?

I have read and agree to the Terms and Conditions in the link below:

https://bit.ly/3iaLmVa

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