Adoption Application

PLEASE NOTE: Completing this adoption application form is merely the first step towards adopting a Boston terrier. By submitting this completed application, you are neither guaranteed nor obligated to adopt a dog. This is merely the beginning of a process that will include vet references, phone interviews and home visits.

You can also download the adoption-application-form and send it in once complete.

Fields marked with an * are required

Household Information

Please list the name, age, and relationship of all members of your household, including yourself.

Please how many children and their ages.


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

(Ranch, two level, etc)


NE Boston Terrier Rescue requires a totally fenced in yard for ALL adopted dogs.  It is for the safety and well-being of the dogs that we require this.  We know that Boston terriers are indoor dogs, however due to 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, please continue to complete and submit this application.  If there are no plans for a fence you will not qualify.

Please select the style of the fences on your property. Check all that apply.

Veterinarian Information

Please provide the contact information for your current veterinarian or the one you will use with this dog.


Please provide two references we may contact regarding this adoption.

Reference 1

Reference 2

Current and Past Pets

Please include type of pet (dog, cat), breed, age, gender, and whether the pet is spayed or neutered

Adoption Information

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.

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

Your application will be reviewed and if additional information is needed you will be contacted and a home visit will then be scheduled.