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Adoption Application


Please note: Only suitable applicants for the basset hounds currently posted will be contacted.

Completing this application does not put the applicant or the rescue group under any obligation.

All information is kept strictly confidential.

Application MUST be completed in full.

Contact Information
Date:
Name of applicant:
Co-applicant:
Address:
Unit Number:
City:
Province/State:
Postal Code/Zip Code:
Primary Telephone#:
Secondary Telephone#:
Email:

Family and Home Information
What type of home do you live in? Single detached home   Apartment   Condo   Townhouse   Other
Do you own or rent your home? Own   Rent
PLEASE NOTE:  If you rent, you MUST include the name AND
the contact information for your landlord or property manager.
Name of landlord:
Landlord phone number:

How many adults are living in the home:
Do you have any children living in the home? Yes  No
Please list the number and ages of the children living in your home:
Do you have children (eg. grandchildren), visiting your home regularly?
If so, please list their ages:
Does any family member
have allergies to animals?		 Yes  No
If yes, please explain:
Do you currently have a dog(s)? Yes  No
If so, please list the age, breed and gender of all dogs in the home:
Are all dogs spayed/neutered? Yes  No
If not spayed/neutered, please explain why:
Are these dogs obedience trained? Yes  No
How does your dog(s) react to other dogs?
Do you have any other pets in the home? Yes  No
If so, please specify:
How do these pets react to other dogs?
Is your yard FULLY enclosed
by a fence and gated?		 Yes  No
Please describe your fencing in detail.
If your yard is not fully fenced, how do you intend to
keep your basset safe while out for potty breaks?
Do you have a swimming pool, pond
or any body of water? Please check all that apply.		 Pool    Pond   Other type of water
If you have a pool, pond or any body of water, is it fenced separately from the area
the basset will have access to?   Yes  No
Please list all dogs you have owned previously including what happened with them.
Have you ever given an animal up? Yes  No
If you've given an animal up, what were the circumstances?

Care of Your Basset
How long would your basset be left alone during a typical day?
Would your basset have access to a toilet area
while family is absent?   Yes  No
Are you willing to housetrain a basset?   Yes  No
Where will you keep your basset during the day?
Where will you keep your basset at night?
How will you alleviate basset boredom during your
absences from the home (eg. while at work)?
Where will your basset stay while you vacation?
Have you researched the basset hound breed to learn about their unique
characteristics, idiosyncrasies, potential health issues, etc?   Yes  No
Why are you interested in this breed?
Are there any basset characteristics that you find
unappealing or have concern about?
How do all family members feel about the following...
chewing:
drooling:
shedding:
hound odor:
ear cleaning needs:
tendency to wander:
howling:
digging:

References
Please list a veterinary reference, who we may contact, who knows or has known you and your animals.
Name of Clinic and Veterinarian:
Veterinarian's phone number:


**  Very Important!   Please be sure to let your veterinarian know we will be calling them,
and be sure to give them permission to speak with us.  **

Please list a personal reference, whom we may contact, who knows or has known you and your animals.
Name:
Relationship:
Phone number:
Important:
** Please inform your references that we will be contacting them. **
** And please give them permission to speak with us. **

Preferences:
Do you prefer:    Male    Female   Either
Do you have a preferred age range:   
Would you consider adopting a basset out of that age range?
Would you consider a basset with special needs?   Yes  No
If yes, do you have experience with special needs animals?   Yes  No
If yes, please explain:
Are you interested in a specific basset?
If so, which basset and why are you interested in him/her?
How far are you willing to travel to meet and adopt a basset?
Please add any additional comments you may have:

Please be advised that a home visit may be required before your application can be approved. We request that all family members be present at this interview.
By submitting this application, you state that all information is true and accurate.
  

Thank you for your interest in adopting a basset through rescue.
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