Date: _______________________________ Rescue Dog # ____________

ONLINE ADOPTION APPLICATION

Name: _________________________________________________________________________________________

(Husband and Wife, if married)

Address: ________________________________________________________________________________________

City: __________________________________________ State: _______________ Zip: _______

Home phone: ________________________ Work phone: ________________________ Work hours: _____ to ______

Email address: ___________________________________________________________________________________

Referred by: _____________________________________________________________________________________

A successful adoption depends on both the selection of the right basset for your household and the understanding of his/her caretaking needs. So that we may assist you with this selection, please answer the following questions as completely as possible. Thank you.

Your Occupation: _________________________________________________________________________________

Do you own or rent your home? ______________________________________________________________________

Type of dwelling (circle one): House / Condo / Apartment / Mobile Home

 

NOTE: IF YOU RENT, PLEASE SUBMIT A COPY OF RENTAL AGREEMENT WHICH ALLOWS DOGS.

Do you have a fenced area or yard for the dog? __________________________________________________________

If yes, type of fence: _______________ Length ______________ Width ______________ Height ____________

If not, what arrangements will you have for the dog's exercise and toilet duties?

________________________________________________________________________________________________

Have you ever owned a dog before? ____________ If yes, what type of breed(s)?: _____________________________

Have you ever owned a basset hound before? ____________ Why do you want to own a basset?:

________________________________________________________________________________________________

Do you presently have other animals?

_________________________________________________________________________________________________

TYPE

BREED

GENDER (ALTERED?)

HOW LONG HAVE YOU OWNED THIS ANIMAL?

       
       
       
       

 How many adults in household? ______________ How many children? __________________

What are the ages and genders of children?

____________________________________________________________________________________________

How do other family members feel about getting a basset?

______________________________________________________________________________________________

 





REFERENCES:

NAME

ADDRESS

PHONE #

EMAIL

       
       
       

Is anyone home during the day? ____________ At night? ____________ Do you have a doggie door?

___________________________________________________________________________________________

Where will the dog be kept during the day? ___________________________________________________________

At night? _____________________________________________________________________________________

Is anyone in the home allergic to dogs? __________ Are you willing to house train the dog, if necessary?

_____________________________________________________________________________________________

When are you away from home? _____________________________________________________________________

Are you established with a vet? _____________ Name of Vet? ______________________________________

Address of Vet? ________________________________________ Phone # of Vet?: ___________________________

 

All of the information I have provided on this application is, to the best of my knowledge, true and complete. I understand that falsifying answers on this application, or at any other time during the adoption process, disqualifies me from adoption.

_________________________________________________________________________________
Signature of applicant and Date

Please return this signed application to:

, President
Basset Rescue of Montana
14600 Springhill Road
Frenchtown, Montana 59834

http://www.bassetrescueofmontana.org

*************************************************************************************************

Date of interview: ___________________________________ Approved by: ________________________________

Comments: ______________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________