Which dog(s) on our website would you like to learn more about at this time?

***Note that our number one objective is finding the perfect home for our rescued dog.  Multiple applications are received daily for each dog we have available for adoption.  If we feel that you are a possible match for the dog(s) you listed we will contact you for an interview, otherwise we will file your application for six(6) months and contact you as soon as the right Boston comes along that fits what you are looking for.  In the meantime, we encourage you to check our website on a weekly basis as dogs are added every week. If a dog is listed that you would like to learn more about email us or call us, no need to submit another application.

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

We ask that you be honest and complete in your responses to ensure the best possible match for a new Boston Terrier in your home. 

About the Adopting Family

First Name    Last Name

E-Mail Address(s) (Our preferred source for communication)

Street Address    City     State    Zip Code

Home Phone    Work Phone    Cell Phone

Best Time to Call (i.e. any, days, nights, weekends)                   

Who in the household will be responsible for this pet?

List all persons residing in the household (include yourself, spouse, friends, and any children who live in the house on a permit basis)

Are there plans for (more) children in the future?    Yes    No

How many children VISIT your home and what are their ages?

Living Situation

How long have you lived at the present address?                      Months Years

Do you rent or own your home? rent    own

 *Please note that renters must include documentation from the landlord that dogs are allowed to live in this dwelling.

What style is your home?  Ranch  Multiple Story   Other-i.e. apartment & what floor, mobile home

If you move what will you do with this pet?

Where will the pet be kept.....

        While you are at work?

        At bedtime? 

        When your are running errands?

        When on vacation?

On average how long will this pet be left alone each day? (Note if you come home for lunch or have split work shifts)

*MABTR requires a fenced in area from families who live in house, however we DO adopt to apartment complexes and communities where fences are not allowed.  In these cases the leash law will be enforced. 

We know that Boston Terriers are indoor dogs, however due their activity level they still require freedom outdoors without a leash. 

Choose your fence type/height (choose one):   

4 ft chain    5 ft chain    6 ft wood      6 ft plastic    Invisible fencing     No Fence

**If you do not currently have a fence please explain why in the Comments section at the end of this application.

Will your dog have access to the following...    Doggie door    Visits to other homes with dogs    Dog Park

References

Please provide name and contact information for your veterinarian, or the one you will use for this pet.

Vet Clinic Name

Address

Phone Number

Please list two other references we may contact regarding this adoption. We will note contact the references without informing you. References are REQUIRED.

    Reference #1.

        Name

        Phone Number

    Reference #2.

        Name

        Phone Number

Household Pet Status

Please list all types of pets (cat, dog, birds, etc) currently residing in the house. Include breed, age and gender.

If any of your pets is NOT spayed or neutered, please explain why: 

MABTR promotes spay and neutering due to the overpopulation of unwanted pets.  This is why MABTR exist.

If you have lost a pet or it died at an early age or due to an accident, please provide details on how:

If you have ever given up a pet or pet one to sleep, please provide details on why:

If you have ever surrendered a pet to a shelter or rescue group before please provide details on why:

How much money do you plan of spending or do spend on your pet(s) each year (food, vet, boarding, toys, etc.)

About the Dog you are looking for

Would you be willing to accept a dog with some health problems?        Yes/Maybe    No

Would you be willing to accept a dog that is not housebroken?             Yes/Maybe     No

*Note that 65% of our Bostons are from puppy mills. They arrive not potty trained and in many cases will not be adopted out potty trained though we start training within foster care.  We do however receive potty trained dog but not often.

Would you be willing to accept a dog with some behavior problems?    Yes/Maybe    No

Explain the size, gender (female, male or either) and personality of the dog you are looking to adopt. 

Please be as detailed as possible so that we can ensure the right match.

What age range would you consider adopting?  Note that we get dogs in as young as newborns to 11 years old.  Boston Terriers have an average life span of 14 years.  Please indicate a range of ages you are open to or state "any age".

Would you consider adopting a Boston Terrier MIX?    Yes/Maybe     No

Additional Facts

Are you applying for the "Golden Paws for Golden Years" program?     Yes    No

*MABTR program places adult dogs (7 years of age or older) with qualified senior citizens who are 60 years of age or older.  Those that qualify get $50 off the listed adoption fee.

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?    Yes    No

    ***MABTR has a great network of transport volunteers. With that said your travel requirements to meet your new dog is minimal. 

    We have transports in and out of all three states that we foster to all the states we provide service in. 

COMMENTS: **If you do not currently have a fence please explain why in the Comments section.

By submitting this form you are declaring that all the information contained above is true and correct. That you are over 18 years of age and a decision maker in the household. That you are looking to adopt a pet and accept full responsibility for his/her care.

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

MABTR will take into consideration the Bostons that you express an interest in to see if they will match your home situation.  We act in the best interest of the rescued Boston...not the potential adopter.  Sometimes for various reasons a particular Boston would not fit in a particular home.

We will keep applications on file for the period of three(3) months.
 

By submitting this application I give permission to contact the references above.

If you DO NOT receive a response from MABTR via email within three days of submitting this application please call us or email us directly.

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