ABC Basset Hound Rescue, Inc.
P.O. Box 54
(Please Print)
Name: __________________________________________________________________
Address: ________________________________________________________________
City: __________________ State: _______________________ Zip: ________________
Home Phone: _______________________ Work Phone: _________________________
Fax: _______________________________ Email: ______________________________
How did you hear about ABC Basset Hound Rescue, Inc.? ________________________
How many members in your household? _______________________________________
List the ages of the children living in your household? ____________________________
Are all members of the household in favor of becoming a foster family? Y / N
Are you established with a veterinarian? Y / N
Please provide the following information about your veterinarian.
Name: __________________________________________________________________
Organization: ____________________________________________________________
Street Address: ___________________________________________________________
City: ______________________ State: ____________________ Zip: ______________
Phone: _________________________________________________________________
Have you ever owned a Basset Hound before? Y / N
If you have previously owned a basset, please tell us a little about him or her: _________
Have you had or do you have any other pets? Y /N
If yes, what kind? _________________________________________________________
Are all of your pets up to date on their vaccinations? Y / N
Type of dwelling (circle one): Single Family Two Family Multi Family Apartment
If you rent, Please provide the following landlord contact information:
Name: __________________________________________________________________
Address: ________________________________________________________________
City: _________________________ State: ____________________ Zip:_____________
Phone: _________________________________________________________________
Is your yard fenced? (not a requirement) Y / N
Are you willing to have your entire family present for a home visit prior to fostering a rescued basset? Y / N
Are you familiar with the Basset breed? Y / N
Do you believe in crate training? Y / N
Do you understand that foster bassets are required to sleep indoors at night, and not allowed to roam loose outside in an unfenced area? Y / N
How often will the basset be left alone? ___________________________________
While you are away, where will the basset hound be? ____________________________
Briefly explain your interest in fostering a basset: _______________________________
Do you agree to assume the responsibility of veterinary care for your foster basset? (Approved veterinary costs will be paid by ABC Basset Rescue, Inc) Y / N
Are you willing to take your Foster Basset outside multiple times a day to relieve him/herself, and for exercise? Y / N
Do you agree to housebreak your foster dog if necessary? Y / N
Do you promise to keep identification on the foster dog at all times? Y / N
Do you agree to notify ABC Basset Rescue if your Foster dog is ever lost, seriously injured, or stolen? Y / N
Do you understand that while the basset is in foster care he/she remains the property of ABC Basset Rescue, and can not be placed without the consent of an ABC representative? Y / N
All the information that is included in this application is to the best of my knowledge, true and complete. I understand that falsifying information on this application, or at any other time during the application process, disqualifies me from approval.
I am aware that submitting my application does not guarantee that I will receive approval to foster a dog from ABC Basset Hound Rescue, Inc.
By signing this application, I authorize ABC Basset Hound Rescue, Inc. access to my veterinary records.
Signature: _______________________________________________________________
Date: ___________________________________________