Please provide us with the following contact information:

Your Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Work Phone
Home Phone
FAX
E-mail

How did you hear about us?

So that we may assist you in selecting the right Basset Hound for your home, please answer the following questions as completely as possible.

How many members are in your household?

Ages of children living in your household?

How long, in hours, would a dog be left alone in your home on any given day?

Hours

Are you established with a veterinarian?

Yes
No

Please provide the following information about your Veterinarian.

Note: Past responsible pet ownership is a key deciding factor in approving homes for adoption.
 
Please contact your Veterinarian office within 24 hrs. of submitting this application and let them know that you have applied to adopt a basset hound and give your permission for them to share information with ABC Basset Hound Rescue's adoption coordinator.

Phone interviews will be scheduled after veterinary references are checked.

Veterinarian Name
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Phone

Have you ever owned a dog before?

Yes
No

What Kind?

Is the dog still with you? If not, why?

Are there currently any pets in the household?

Yes
No

If yes, what kind?

Would this dog primarily be an inside dog?

Yes
No

Do you own or rent your home?

Own
Rent

If you rent, Please provide the following landlord contact information :

Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Phone

Do you have a fenced yard?

Yes
No

Are you willing to have your entire family present for a home visit prior to the adoption?

Yes
No

Are you willing to take your new Basset Hound to the vet within 10 days of the adoption for a physical?

Yes
No

Do you have an age preference for the Basset you wish to adopt?

Yes
No

Years

Do you have an gender preference for the Basset you wish to adopt?

Yes
No

Male
Female

Please provide any further information that you feel is pertinent.