adoption application

adoption application January 30, 2013

name(required)

street address(required)

city(required)

state(required)

zip code(required)

home phone(required)

cell phone

Our goal is to complete home visits within 7 days, will that work for you?(required)

e-mail address(required)

How old are you?(required)

Have you previously owned a dog?(required)

If yes, what breed(s)?

If so, for how long?

What happened to your previous dog(s)?

What qualities are you looking for in a dog?(required)

Have you researched basset hounds?(required)

Describe what you know about bassets.(required)

List your veterinarian's name and phone number. (We may contact your vet. Please let his or her office know it is okay to share information with BHRSC.)(required)

I agree for my vet to be contacted regarding my application(required)

What is your hound age preference?(required)

Do you have a dog preference?(required)

Do you have children living in your home?(required)

If yes, what ages?

Are you willing to house train a dog?(required)

Where do you live?(required)

How many stories in your residence?(required)

Do you own or rent?(required)

If renting, list your landlord's name and contact information.

Is your property fenced?(required)

If not fenced, what is your exercise plan?

Do you have a dog door?(required)

Do you have a pool?(required)

Where will the dog stay during the day?

Where will the dog sleep at night?(required)

Do you have a dog(s)?(required)

If yes, is your dog(s) spayed or neutered?

List the breed, gender and age of each dog you own.

Which hound(s) on our website are you interested in meeting?(required)

Provide any additional information you think we should know.

How did you hear about us?(required)

After your adoption, would you be interested in volunteering for BHRSC?(required)

Would you be interested in fostering after you adopt?(required)

After your adoption, would you be interested in completing home visits?(required)

By sending this form to Basset Hound Rescue of Southern California:

1. I confirm all of the information provided is true and complete to the best of my knowledge.

2. I understand an in home visit will be conducted by a BHRSC volunteer and landlord consent must be validated (if renting) prior to adoption approval.

3. I understand there is a donation (payable to BHRSC) requested with the adoption of a basset hound to help cover the costs of rescue, spay/neuter, vaccination, etc.

4. I agree to return the dog to BHRSC if the adoption does not work out for any reason.

It may take up to four business days for a rescue representative to reply.
You will be contacted via e-mail so please be sure that your e-mail address is correct.
Please submit only one application.

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Basset Hound Rescue

of Southern California