Adoption Application

Thank you for your interest in adopting one of our Boston Terriers!At this time, we cannot process ALL new applications.

However, if your application is a match for one of our foster dogs, who is ready for adoption, you will be contacted.

Although we cannot guarantee that you will be matched with the dog you applied for or any dog at this time, all matching applications will go through a complete screening process prior to adoption. The process is thorough and can seem lengthy. Due to the few dogs we have available at this time, the large number of applications we receive, and the restrictions by each state due to Covid, it will take some time. Your patience is much appreciated as we work through it together!–

E-mail Address: *

Name/Names: *

Date Submitted: *

Your age or ages: *

Name of Dog you are interested in:

Why are you interested in this dog?:

Street Address: *

City: *

State: *

Zip: *

County: *

Home phone: *

Cell phone:

Do you have an application with other rescue groups?

Yes No

Do you have children?

Yes No

Names and ages:

Occupations of adults in your home?

Do you own or rent? *

Own Rent

Landlord Name:

Landlord Phone Number:

Best time to call:

Landlord EMail Address

Reference Name:

Reference Phone:

Reference Email Address:

Best time to call:

Veterinarian Used in the past 3 years:

Veterinarian phone number:

Veterinarian Address:

Please list all pets you own or have owned in the past 5 years, not lincluding those listed above, and indicate where they are now.

Please describe your current dogs behavior around other dogs.

If you lost a pet, or it died at an early age, or was put up for adoption, please provide details:

Have you ever given up a pet? If so, when and why?

What would you do if you adopted a dog and problems developed between the new dog and the resident dog(s)?

Do you have a cat(s)?

Yes No

How many?

Do you have a fenced yard?

Yes No

If yes, what type of fence and how high is it?

How long would a dog be alone at home most days of the week?

If you are gone for more than 8 hours, do you plan to have a dog walker or use a doggy daycare?

Yes No

If you choose not to have a dog walker or doggy daycare, what are your plans for feeding/water, exercising and allowing a dog to eliminate if you are gone for an extended period of time during the day?

Do you have specific requirements as to age and sex, or are you willing to consider any dog whose personality is a good match for your home?

We occasionally have dogs who have typical, loving Boston Terrier personalities but who have special needs of some kind, or who are elderly. Would you be willing to consider one of these dogs?

Yes No

Would you be willing to accept one with health problems?

Yes No Maybe

Allergies:

Yes No Maybe

Seizures:

Yes No Maybe

One eye:

Yes No Maybe

Blindness:

Yes No Maybe

Deafness:

Yes No Maybe

3 Legs:

Yes No Maybe

On medication:

Yes No Maybe

Restricted/special diet:

Yes No Maybe

Would you be willing to accept one that needs more work on housebreaking:

Yes No

Would you take one with behavior problems? e.g., loves people but doesnt like other dogs; has separation anxiety; is cautious with strangers

We occasionally take in dogs who have been puppy mill breeders their whole lives and who need to learn everything from the beginning - housebreaking, how to trust people, how to play with toys, how to live inside a house, etc. Though they begin this journey with us while in foster care their adaptation to a loving home can take some time. Are you interested in being considered for one of these needy but very deserving dogs?

Yes No Maybe

Can you describe any special qualities about you or your home, or any previous experience you may have had, that would help you to take care of a special needs dog?

If you move, what will you do with the Boston Terrier?

If you become ill, pass away, or otherwise become unable to care for the dog, what arrangements would you make? (Please note: Except in approved circumstances the dog would be required to be returned to NEBTR)

Where will the dog go for exercise and elimination?

How will you exercise the dog?

Where will the dog be kept: During the day:

At night:

When no one is home:

When you are on vacation:

Are your dogs vaccinations up to date, or have they been titered? If not, please explain.

Will you consider a Boston Terrier mix?

Yes No

Will you consider adopting a bonded pair?

Yes No

We cover NY, NJ, PA, MD, RI, DE, CT, VT, MA, and ME. How far would you be willing to travel to adopt?

How did you hear about us?

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Adoption Application

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