MidAmerica Boston Terrier Rescue

Adoption Application

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Completing this application is merely the first step towards adopting a Boston Terrier. By submitting this competed application, you are neither guaranteed nor obligated to adopt a dog. This is merely the beginning of a process that will include vet referenced, phone interviews and home visits.  You only need to complete one application per household NOT per dog.

MABTR adopts only to residents in Nebraska, Colorado, Iowa, Kansas, Minnesota, Missouri, North and South Dakota, and Wyoming.

MABTR requires a fenced in area for families who live in house.  We DO adopt to apartment complexes though fences do not exist.

DO NOT USE THE "ENTER" WHEN FILLING OUT THIS ONLINE FORM

First Name    Last Name

E-Mail Address

Street Address    City     State  Zip Code

Home Phone    Work Phone    Cell Phone

Best Time to Call                   

How long have you lived at the present address?               

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, mobile home

 

If you move what will you do with this pet?

 

Where will the pet be kept.....

        While at work?

        At bedtime?   

        When no one is home

        When on vacation

 

On average how long will this pet be left alone each day?

 

Additional exercise and elimination options available for the pet...    Doggie door    Dog Park    Future plans for a fenced in area

* A totally fenced in area is required for families applying that live in a house.  It is for the safety and well-being of the dogs.  We know that Boston Terriers are indoor dogs, however due their activity level they still require freedom outdoors without a leash.  If you do not currently have a fenced yard, but are planning on getting one OR live in an apartment complex, please continue to complete and submit this application. 

 

Choose the height of your fence    4 foot    5 foot    6 foot

 

Choose the type of fence you have    Wood    Plastic     Chain link

 

Who will be responsible for this pet?

 

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

Vet Clinic Name

Address

Phone Number

 

Please list two other references we may contact regarding this adoption

    Reference #1.

        Name

        Phone Number

 

    Reference #2.

        Name

        Phone Number

 

Please list all types of pets (cat, dog, etc) including breed, age and gender that currently live in the household:

            Type                                      Breed                                     Age                            Spay or Neuter?                      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:

 

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

 

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

 

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

 

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

 

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

 

Explain the size, sex and personality of the dog you prefer to adopt.

 

What age range would you consider adopting?   

 

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

 

List all adopters residing in the household (include yourself and any children in the household)

 

        Name                                    Age                                        Relation

                

                

                

                

                

                

 

Are there plans for children in the future?    Yes    No

 

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

 

I would like more information on the Boston Terrier breed.     Yes    No

 

How did you hear about MidAmerica Boston Terrier Rescue?

 

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.  If we feel

that you are a possible match for the dog(s) listed above then we will contact you for an interview, otherwise we will file your application for 6 months

and contact you as soon as the right Boston comes along.  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.

 

Would you be willing to drive part way to meet and pick up your new pet?    Yes    No

 

COMMENTS:

 

By submitting this form you are certifying that all information contained above is true and correct. That you are over 18 years of age and the person responsible for making pet decisions in your family. That you are looking to adopt a pet, give it a good and loving home as a pet owner and accept full responsibility for his/her care.

 

I agree to abide by all state and local pet control and leash laws. I understand it is my responsibility to become familiar with these laws.

 

We will take into consideration the Boston9s0 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 six (6) months.
 

By submitting this application I certify that the above information is correct, and 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.