Basset and Beagle Rescue of the

Basset and Beagle Rescue of the Heartland

Fostering Application

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

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