1. First Name
2. Last Name
2a. E-mail
3. Address
4. City
5. State
6. Zip code
7. Home Phone
7a. Work Phone
8. Preferred Sex
 Male
Female
9. Age Preferred
10. Why do you want to adopt a basset hound?
11. Are all members in your household
      wanting to adopt a basset hound?
No
Yes
Yes
No
12. Are you a first time dog owner?
13.How many adults & children in       
       your household?
14. What is the age(s) of the  adults   
      and children in your household?
15. Please list the names of  your
pets & ages you had for the last ten
years?
16. Have you ever taken an                     
animal to a shelter or  pound or returned a
dog to a animal rescue group?
Yes
No
17. If yes, what were the                        
      circumstances?
18. Type of housing?
19. Do you currently own or rent?
Own
Rent
20. If renting, do you  have your               
       landlords permission to have a       
      basset hound?
Yes
No
20a. If yes, please provide your landlord's
         name and phone number
21. Where would your new basset hound  
      stay during the day?
22. Where would your new basset hound
      stay at night?
23. Do you have a fenced in yard?
No
Yes
24. If yes, please describe the size, type
      and of your fenced in area? Is fence   
      completely closed in?
25. Do you have a swimming Pool,        
   Hot tub or Pond ? If yes, what type of
cover  do use?
26. How many hours will your basset    
       be alone during the day?
27. Where will you leave your basset  
       when no one is home?
28. Who will be responsible for your
basset's training?
29. Will you keep identification on   
       your basset at all times?
Yes
No
30. Do all members of your            
       household understand that it  
       takes time for a dog to adjust
       to a new home?
Yes
No
31. Do you know  that your       
       new basset would              
       require veterinary care,      
       year vaccinations, &            
       monthly heart worm            
       prevention?
Yes
 No
32. Do you agree to notify       
Ohio Basset Rescue
immediately if your basset
gets lost?
Yes
No
33.Do you agree that an your
new adopted basset will be
kept exclusively as a house
pet and will never be tied out
or chained to a dog house or
any other object?
Yes
No
34. Do you agree that if, for any reason you
cannot keep your adopted basset hound that
you would notify Ohio Basset Rescue
immediately and never give it too a shelter, a
pound or anyone else?
Yes
No
Please notify your current veterinarian or past vet used that
Ohio Basset Rescue will be contacting them and please
give them your permission to let them verify any of your
current or past pets medial bills
35. Veterinarian
35a. Area code & Phone Number
35b. Name under which your records are kept?
36 a&b. Please list two personal references
+ phone numbers
36c. Please leave us any additional information
you feel is necessary
37. Please read and type "I agree" or your name  below that all the
above 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 any other time during the adoption process,
disqualifies me from adoption with Ohio Basset Rescue.
OBR's Adoption Application
Thank you for filling out Ohio Basset Rescue's Online Adoption
Application. Our goal is to adopt Basset Hound into permanent,
loving, and responsible homes. This information  will help us find
the best Basset Hound for you and your family. Our adoption fees
for basset hounds under a year old are $250, bassets hounds 1-
8 years old are $200 and basset hounds 8 years and older are
$125.

All dogs are spayed/neutered, inoculated (includes rabies and
bordatella vaccinations) heart worm tested and kept on a  monthly
heart worm preventative prior to adoption. No Adoption donations
will be refunded because it goes to pay for all their medical
needs before adoption.

Potential adopters are required to complete and submit an
application as the first step in the adoption process. Potential
adopters will not be permitted to set a meeting with a rescue dog in
a foster home until they have been approved application with Ohio
Basset Rescue. Please be respectful to our volunteers because
they donate all their time & energy for  free to help rescue
abandoned and abused basset hounds
To mail in your application please send to:

Maribeth Walker
3555 Anderson
Minerva, Ohio 44657
adopt@ohiobassetrescue.org
Important

Please call your
Veterinarian and give
them permission that
would allow  Ohio Basset
Rescue to check the
records for your pets.


Without permission your
application cannot be
approved