Foster Application

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? *

Please verify that you are human *

*

By submitting this application, I/we agree that all the information provided is true and accurate to the best of my/our knowledge.