Basset Hound Rescue of San Diego P.O. Box 60130 San Diego, CA 92160 ADOPTION APPLICATION Please print, complete and mail this application to the address above. Name: ______________________________________________________ (Husband & Wife, If Married) Address:_____________________________________________________ City: _____________________ State: ____________ Zip: ____________ Home Phone: _________ Work Phone: __________ Work Hours: ______ Referred by: __________________________________________________ A successful adoption depends on both the selection of the right Basset for your house hold 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. Do you own or rent your home? _____ Type of dwelling: Home: ____ Condo: ____ Apartment: ____ Mobile Home: ____ Do you have a fenced area or yard for the dog? ____ If yes, type of fence: _______ Length: ____ Width: ____ Height: ____ If not, what type of arrangements will you have for the dog's exercise and toilet duties? _____________________________________________ Have you ever owned a dog before? ____ Breed(s): __________________ Have you ever owned a Basset before? ____ Why do you want a Basset? ______________________________________ Do you presently have any other animals? ____ Type Breed Sex (M/F, altered?) How Long Owned? _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ How many adults in the household? ___________ Children? ___________ Ages and sex of children: ________________________________________ How do other family members feel about getting a Basset? _____________ _____________________________________________________________ Is anyone home during the day? _______________ At night? ___________ Is anyone in the home allergic to dogs? ____ Are you willing to housetrain the dog if necessary? ____ Where will the dog be kept during the day? __________________________ At night? ____________________________________________________ When you are away from home? ________________________________ Are you established with a veterinarian? ____ Are you willing to have a home visit before adoption? ____ 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: _________________________________ Date: ______________ ----------------------------------------------------------------------------------- This section for Basset Hound Rescue of San Diego use only. Date of interview: _________ Approved by: ________________________ Comments:____________________________________________________ _____________________________________________________________ _____________________________________________________________