Oregon Basset Hound Rescue Adoption Application Form
A successful adoption depends on matching the selection of the right Basset for your household and our understanding of the dog’s individual needs. So that we may assist both parties with this selection process, please answer the following questions as completely as possible. The bold areas must be completed, if you are unsure on answering other areas,please leave a blank. The more completely you answer, the better we can match up dogs with homes.
Thank you.
Name: *
ex: John Smith
Your answer
Street Address: *
ex: 101 Main Street
Your answer
City: *
ex: Keizer
Your answer
State: *
ex: OR
Your answer
Zip: *
ex: 97307
Your answer
Home Phone: *
ex: 555-555-5555
Your answer
Best hours to contact you? *
ex: 6-8 PM
Your answer
Email address: *
Your answer
Referred to us or found us via *
ex: web search
Your answer
Do you have preferences about the Basset Hound you wish to adopt? *
If yes, you must give us some guidelines. Please list any specific preferences on th elines below (e.g. sex, color, age limits, etc.)
Your answer
Plesae check the boxe(s) that best describe the Basset of your dreams. *
Required
Have you ever owned a dog before? *
If yes, what breeds?
Your answer
Have you ever owned a Basset before? *
Do you presently own any other animals? *
If yes, type what breed, sex altered and how long you have that animal.
Your answer
Why do you want to own a Basset? *
Your answer
Number of adults in your household? *
ex: 2
Your answer
Number of children in your household? *
ex: 0
Your answer
If you have children in the household, please list name and age of children
Your answer
How do other members of the family feel about adopting a Basset Hound? *
Your answer
Is anyone at home allergic to dogs? *
If so, why?
Your answer
Are you willing to housetrain a dog if necessary? *
Check if you would like an inside, an outside dog or check both if you want either. *
Required
Do you own or rent your home? *
How long have you lived there? *
Your answer
If renting, do you have written permission from the landlord to have a dog?
Dwelling type: *
Backyard Dwellings
Bassets will wander off if they are not on a leash or behind a fence. If tied out, a basset
is miserable and your neighbors will hear about it. They usually do not return if they wander off.
Do you have a fenced area with shelter ready for a a dog? *
If yes, type in type of fence, length, width and height
Your answer
Will someone usually be home with the dog during the day? *
Will someone usually be home with the dog during the night? *
Where will the dog be kept during the day? *
Your answer
Where will the dog be kept during the night? *
Your answer
Where will the dog be kept whe you are away from home? *
Your answer
All dogs need to have shots or titers updated every year, with a rabies booster every third year. Arfe you established with a vet? *
If yes, type in the vet information.
Your answer
May a rescue representative make a home visit prior to adoption? *
Is there anything else you feel you need us to know?
Your answer
Signature(s) of Agreement
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. I also understand that there is a fee for adopting a rescue basset and it will help to cover health care and placement costs of needy bassets that find their way to this non-profit rescue service.
Signature(s) of Applications(s) *
ex: John Smith
Your answer
Date: *
ex: 01/01/2012
Your answer
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