Name
*
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
Please enter a valid phone number.
Who were you referred by?
Are you established with a Veterinarian?
Vet's name & telephone number
How many adults in your household?
Number & ages of children in household
Do you own or rent your home?
If renting, landlord name & phone number
Type of dwelling (single family, multi-family; condo or apartment)?
Do you have fenced yard? If yes, describe fence material and height
Have you owned a Basset Hound before?
Number & breed(s) of dog(s) currently
Number of cats currently
Are all pets spayed/neutered?
Why do you want to foster a Basset Hound?
Are you willing to housetrain?
Are you willing to crate train?
Do you understand importance of keeping foster dog on leash or in fenced yard?
Do you agree never to let your foster dog loose outdoors?
Do you agree never to use an electric fence to contain your foster dog?
Do you agree to obtain necessary veterinary care (at NEBHR's expense) for your foster dog?
Approx. number of hours foster dog will be alone during the day
Where will you be keeping foster dog while at work or away from home?
Do you agree to keep foster dog in the house and treat as a family pet?
Are you willing to take foster dog outside at least 4 times a day to relieve him/herself?
Do you agree to notify NEBHR if you experience any behavioral issues?
Do you agree to notify NEBHR immediately if foster dog becomes lost or stolen?
Do you agree to keep a buckle collar bearing identification on your foster dog?
*
By submitting this application, I/we agree that all the information provided is true and accurate to the best of my/our knowledge.
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