Adoption Application

This application helps Fox Terrier Rescue of Colorado find the best dog for your lifestyle.
We’ll do our best to find you or your family a new Foxie friend!

Directions:

Complete the application below.
Click the button at the end to send it to us.

Thank you!

Fox Terrier Rescue of Colorado respects your privacy -
we do not sell or release your personal information.

Contact/Personal Information

Name
Street Address
City
State
Zip Code
Phone
Alt. Phone
E-mail Address
Occupation-Self
Occupation-Spouse

Single Married Live alone Live with parents Military

Number of children living with you and their ages:

What makes you interested in the Fox Terrier breed?

Living Situation

Single Family Home
Duplex
Apartment
Condo/Townhouse

If you rent, name of landlord and contact information:

Fenced yard:
Yes No

If yes, type of fencing AND height:

Swimming Pool:
Yes No

If yes, is it separately fenced?
Yes No

How many hours each day will the dog be left alone?

What will you do with the dog when you are away?

Dog Ownership History

Have you ever owned a Fox Terrier?
Yes No

If yes, do you still have the dog?
Yes No

What happened to the dog?

Where did you get the dog?

What other breeds have you owned?

What other pets do you currently have?

Name and contact information for your veterinarian:

Have you or an immediate family member ever surrendered a dog to rescue or a shelter?
Yes No

If yes, what were the circumstances?

Have you or an immediate family member ever been charged with animal cruelty?
Yes No

Three references who can verify your pet ownership experience:
1.
2.
3.

Dog Wish List

Gender: Female Male No Preference

Age:

Breed: Smooth Fox Terrier Wire Fox Terrier No Preference

Are you willing to take a dog with special needs (could include potty training, separation anxiety, medical conditions, geriatric?

Yes No Maybe

When could you take possession of your rescue?

Agreement

By checking this box, I agree:

to accept complete responsibility for total care of my Fox Terrier, including regular vet visits, adequate exercise and training.
to a home visit from Fox Terrier Rescue to confirm that I can supply the appropriate environment for my rescue terrier.
to notify Fox Terrier Rescue immediately if I need to relinquish my adopted fox terrier.
to notify Fox Terrier Rescue of any change in my address, phone number and email address.
to make a donation as determined by Fox Terrier Rescue to FTR, which is used to defray ongoing costs of rescue care (like spaying, neutering, medical treatment, food).

Signature/Name: Date: