| Online Adoption/Fostering Application :: Part One |
| Please answer all questions. An incomplete application will slow down the adoption/fostering process. |
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| Which of the following are you most interested in? |
Adoption Only
Fostering Only
Both Adoption and Fostering
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Basset's Name (if known):
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| Your Info |
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First Name:
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Last Name:
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Address:
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City:
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State:
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Zip Code:
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Phone:
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Email:
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Occupation:
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Age:
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Do you own or rent your place of residence?
(If you rent, we will need proof from your landlord that you are allowed to have a dog. A copy of the lease agreement, notarized note from the landlord, etc...)
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Own
Rent
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Do you have a fenced yard?
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Yes
No
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Have you ever owned a basset before?
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Yes
No
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| Are you aware that some bassets may have medical conditions? |
Yes
No
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Medical conditions common to the breed are: fatty cysts, back/disk problems, glaucoma & bloat.
Despite being known as small dogs, the average basset weighs approx. 35lbs to 60lbs and vary in colors such as Tri, mahogany/white, Lemon/white, red/white, etc...
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| Have you ever put a dog to sleep? |
Yes
No
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| If Yes, please tell us briefly why: |
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Why do you want a basset hound?
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| Where will the basset be kept while you are out for the day or at work? |
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| Where will the basset stay when you are on vacation or out of town? |
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| Do you agree that this basset will be an indoor pet and will sleep inside the house? |
Yes
No
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| Are all the adults in the household in agreement on adopting this dog? |
Yes
No
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Your Veterinarian Info |
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Who is your Veterinarian?
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Address:
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City:
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State:
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Zip Code:
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Phone:
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Email:
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| Are there other animals in the household? |
Yes
No
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| If yes, please list what they are, their sex, age, and how many. |
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| Are they spayed/neutered? |
Yes
No
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| Are they vaccinated? |
Yes
No
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| May we verify this with your vet? |
Yes
No
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| What kind of heartworm preventative do you use or plan to use? |
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| Do you understand the necessity of such medications? |
Yes
No
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| If not, have you ever know of a dog that had HEARTWORMS and the severity of the treatment needed to cure the disease? |
Yes
No
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| Are there any children in the household? |
Yes
No
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| If yes, how many and what are their ages? |
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Reference Info - please list two references that we can call or email: |
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| Reference One |
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First Name:
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Last Name:
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Address:
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City:
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State:
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Zip Code:
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Phone:
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Email:
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| Reference Two |
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First Name:
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Last Name:
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Address:
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City:
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State:
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Zip Code:
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Phone:
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Email:
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Are you interested in volunteering to help with basset rescue?
If so, please check the following areas where you may be able to assist us: |
| Fostering short term? |
Fostering long term? |
| Transportation? |
Fund Raising? |
| Special Projects? |
Veterinary Services? |
| Other?
Please Specify: |
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