Make your own free website on
Have you had dogs in the past? If yes, how many? __________ What breeds? ________________
What happened to them? ___________________________________________________________
If you were unable to keep them, why? _______________________________________________
How far are you willing to drive, in hours, to look at a dog? ________________________
Would you consider a special needs dog, such as one that requires daily medication, one who needs obedience training, a deaf dog?:______________________________________________________
Are you familiar with the costs of veterinary care? _____ Licensing requirements? _____
Vaccinations and heartworm preventative? _____
Are you aware of the grooming requirements of an English Setter? _________________
Will you groom the dog yourself or use a groomer? ___________________________
Do you prefer: male______ female ______ either ______ Color: Blue ______ Orange ______ Tri ______ Any ______
Do you have a preference as to age? ______ If so, what age range will you consider?__________
Please List at least 3 references and your vet

ON A SEPARATE PAGE, PLEASE WRITE A BRIEF DESCRIPTION OF YOU AND YOUR FAMILY, INCLUDING ANY SPECIAL ACTIVITIES THE DOG WOULD BE INVLOVED IN, OR SPECIAL REQUIREMENTS YOU HAVE. ALSO PLEASE TELL US WHY YOU WANT TO ADOPT A BOSTON TERRIER I certify that the above information is correct to the best of my knowledge. I understand that any Boston I may adopt must be spayed or neutered. I understand that the Boston Allied Rescue Connection may visit my house, possibly unannounced, to assess the status of the dog and the conditions under which it is being kept. I further understand that if it is felt that the dog's welfare or safety is in jeopardy, or that the terms of the adoption contract are not being upheld, the dog may be reclaimed by the BARC. I will, at that time, surrender the dog on demand and make no further claim against the BARC.. I agree not to allow the dog to run loose anywhere that its safety may be jeopardized, not to chain the dog outside or to leave it in an unsafe environment. I also agree to accept full responsibility for the dog, its shelter, exercise, feeding and health care needs. If I ever cannot keep the dog I understand it MUST be returned to the BARC. I agree to hold BARC.and itís representatives not liable or responsible for any damage to persons or property once the dog leaves their care.

Applicants signature: ______________________________________ Date: ______________

Co-applicants signature: ___________________________________ Date: _______________