Application

Please read CAREFULLY and COMPLETELY

Please answer the following questions honestly and as completely as possible.  By submitting this completed application (found at the end of this page), you are neither guaranteed nor obligated to adopt a dog from our organization.

Cost

There is no cost to complete an application with us.

Dogs over the age of seven they qualify for our Golden Paws for Golden Years program.

The adoption fee is clearly stated in each dog’s online profile. Adoption fees or not negotiable nor will not be discounted.  There are no hidden costs.

Selecting a Dog

Please apply when you feel ready to adopt, as we don’t hold dogs, and we only hold applications for three months. After completing this application, we invite you to check our website regularly for newly posted dogs as new faces arrive weekly, and contact us if you see one you’d like to know more about.

You only need to complete one application per household, not per dog of interest. Just contact us stating you are already on file, the name on the application and the name of the dog(s).

Transport

MABTR will do our best to help transport any adopted dog within the 13 states we serve.

In addition to the adoption fee, we charge a $25 transport fee for any out-of-area adoptions (ie. from Nebraska to Colorado, St Louis to Kansas City, MO) that require us to arrange transportation. This applies where the transport will get your dog part or all the way to your home.

Fences

MABTR requires a ‘fenced-in area’ from families who live in houses, but we DO adopt to apartment complexes and communities where fences are not allowed as a result of enforced leases and covenants. We expect adopters to keep dogs on leash when outside of a secure, fenced-in area.

Processing Time

It may take us up to four days to process your application as we review applications twice a week. If you haven’t heard from us by then, please contact us. Please note that applicants will receive a phone interview if you qualify for the dog of choice and a home visit after the phone interview.

Confidentiality

The information provided below will be kept confidential and not shared with parties outside of MABTR’s organization.  If you are looking at other dogs from other organizations, you will need to contact them directly and complete their adoption application as well.

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Adoption Application

Which dog(s) interest you?

Are you applying for the Golden Paws for Golden Years program ($50 off adopting a dog 7 years and older if you are 60 years and older)? YesNo

Basic Information

First Name: Last Name:

Email:

Phone (cell): Phone (other):

Best Time to Call: wheneverdaynightweekend

Street Address:

City: State:

If you state of residence is not listed we do not adopt to your state due to distance. We apologize for any inconvenience and encourage you to check out www.btrescue.org for those organizations that do.

Zip:

Household Information

Who in your household will be responsible for this pet?

List all persons and AGE residing in your home. (Include yourself, spouse, children, roommates)
Name, Age, Relationship





Are there plans for (more) children in the future? YesNo

Is everyone in your household aware of and on board with your intentions to adopt a dog? YesNo

If something were to happen to you and you could no longer care for your pet, what is your contingency plan?

Living Situation

How long have you lived at this residence?
< 6 months6 months - 1 year1 - 2 years3 - 5 years> 5 years

Do you rent or own? rentown

If you marked "rent," please provide your landlord's name, phone number, and/or email so we can verify that you are allowed to have a dog.

Landlord name:
Landlord phone:
Landlord email:

Type of home:
If you said “apartment,” what floor do you live on?

What kind of fence does your yard have?
No yard/fenceChainlinkWoodPlasticStone/CementOther

What is the height of the fence? No fence3 feet4 feet5 feet6 feet

If you live in a home and do not have a fence, please explain why. Note that MABTR adopts to families in apartments or neighborhoods that do not allow fences as a result of covenants and lease agreements.

Will your dog have access to the following? (Choose all that apply)
Doggie doorSocialization with other dogsDog walks outside of home

References

Please provide two personal references we can contact (only one can be a family member):

Reference 1:
Name:
Phone:
Email:

Reference 2:
Name:
Phone:
Email:

Vet Info:
Clinic:
Veterinarian Name:
Phone:

*Please let your references know that we will be calling, so they are not surprised to receive a call from an unknown phone number.

Current Pets

Please list all animals currently living in your household.
Name, Species, Breed, Age





Do you have any pets that aren't altered (spayed/neutered)? YesNo
If you answered "Yes" to the previous question, please explain why:

Please explain if you have ever had a pet go missing and/or had one die from an accident:

Please explain if you have ever had to put a pet to sleep:

Please explain if you have ever surrendered or returned a pet to a shelter, rescue or individual:

How much money do you plan to spend on your pet each year? (food, vet, boarding, toys, etc.) $.00

How long will your dog be left alone each day?

Where will your dog sleep?

Where will your dog stay when you are away from home (at work, running errands, etc.)?

Behavior

How do you feel about adopting a dog who needs housetraining? (Note: 53% of MABTR dogs are puppy mill survivors. These dogs are NOT housebroken at the time of adoption but can be after a few months of training.)
I am willing to work on housetraining.I prefer potty trained but understand accidents can happen.Accidents inside are unacceptable.

Gender preference: Either Female or MaleFemaleMale

What age range(s) would you be interested in adopting: Any Age<11-34-67-89+

Please mark the characteristics that interest you:
Couch potatoEnergeticKid friendlyDog friendlyCat friendlySmaller sizeLarger sizeMostly quietCuddlerLonerSleeps in dog bedSleeps in your bedShy/timidOutgoingLeash trainedPotty trainedCrate trainedLikes car rides

What behavior(s) are you NOT willing to consider?
JumpsSnores (common)GrowlsChews (puppy stage)TimidPlays roughSeparation anxietyBarksDigsHistory of markingNot leash trained

Dogs with medical challenges still make great pets. Would you consider adopting a dog with any of the following: Separation anxietyBlindDeafAmputeeDiabetes

Would you consider adopting a Boston Terrier MIX? YesNoMaybe

Additional Facts

How did you hear about MidAmerica Boston Terrier Rescue?

Would you be willing to drive part way to meet and pick up your new pet? YesNo

Additional Comments

Please use the space below to tell us more about yourself. For example, do you have experience with health/behavior issues? How do you discipline and house train your current pets? Is there anything else we should know about you that will help us make a perfect match for you?

Please read and acknowledge the following:

"I declare that all the information contained above is true and correct, that I am over 18 years of age, and that I am a decision-maker in my household. I am looking to adopt a pet, and I will accept full responsibility for his/her care." I agree

"I will abide by all state and local pet control and leash laws." I agree

"I give permission to contact the references I've provided." I agree