Basset and Beagle Rescue of the Heartland

Fostering Application

 

 

 

 

 

1) Your Name  
  Address  
  City  
  State  
  Zip Code  
  Home Phone Number  
  Alternate Phone Number  
  Email  
 

Occupation(s)

 

 

2) Number of Children        

Name and Ages of Children

 
 
 
 

 

3)

I would allow someone from BBRH to do a home visit?

 

 

4) Please mark which of the following best describes your current living situation:  
  Ownership  
  Type  
  Location  
     
 

If you Rent or Lease, list the name, address, phone number of your Landlord or Property owner, who holds your lease/rental agreement:

  Landlord/Property Owner  
  Address  
  City  
  State  
  Zip Code  
  Phone Number  

 

  How long have you lived at this address? YearsMonths  
     
  Besides your immediate family, are there others residing in your house?  
  If Yes, please provide Name and Relationship  
   
   
   
     
  Does your home have a yard?  
  If Yes, is it fenced?  
  What typed of fence?  
  How tall is the fence  
       
  Is someone home during the day?  
  If no, where will the dog stay while you are gone?  
  How many hours will the dog be alone during the day?  
 

Where will your dog be kept most of the time? 

 
     
  Do you have any other pets?  
  If Yes, Please provide the following information  

 

  Name Type (Dog, Cat, Etc) Age Current on Vaccinations? Neutered/Spayed?  
   
   
   
   
   
  If you checked no to either question above, please provide details:

 

  Are your animals on heartworm preventative?  
       Type?  
  Have you ever had a neighborhood complaint filed with animal control?  
       (If yes, describe)  

 

5) Your Veterinarian  
   Name
  Address
  City
  State
  Zip Code
  Phone Number
  If applicable, approximate date of your current pet's last office visit:
     
  Have you ever had to give a dog up?
  If yes, what was the circumstance:
 

If you have owned other dogs and do not now, what happened to them?

 

     
6) Your Preferences  
  What sex do you prefer?
  Age range?
  Which breed do you prefer?
  Have you ever owned a Basset Hound or Beagle?
  If yes, tell us about your Basset Hound or Beagle.
     
7) Experience  
  List any Humane Societies, Organizations, Breed or Training Clubs you are associated with
  How long have you been involved with dogs?
  List dog breeds you have had experience with and types of experience (training, showing, breeding, family pet, etc.)
  Have you fostered dogs for another rescue group? Describe
  Do you have confinement to isolate a dog for health reasons (if yes, please specify)?

 

  Will you foster a dog with kennel cough?
  Will you foster a dog that is injured?
  Will you foster puppies?
  Will you foster a dog that has behavior problems?
  Will you foster a dog that is dog aggressive?
  Will you foster a dog that is not housebroken?
  Do you have special skills (trainer, vet, groomer, behaviorist, etc.)? 
     
 

Fostering a dog may put you over the county pet limit, be aware of current county regulations

     
9) References:  
 

Please include address, phone number and how long known

 

 

  Name Address Phone Number Known(yrs-mos) Relationship
 
 
 

 

10) Additional Comments:  
 
     
11) Volunteer  
  Please check the following other areas where you may be able to assist us

Transportation

Fund Raising

Special Projects

Veterinary Services

Other

     Please Specify:

 

I certify that the information provided on this form is true and correct, to the best of my knowledge. I am also financially and physically able to care for this animal. I understand that proper food and veterinarian care can be costly and I am able and willing to meet these requirements. Home checks are made on a random basis following or prior to adoption. If upon inspection we find that the information contained in this application to be false, we retain the right to deny your application and/or remove the animal from your premises without a refund of monies paid.

BBRH  RESERVES  THE  RIGHT  TO  REFUSE  ADOPTION  FOR  ANY  REASON

 

 

   

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