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Seattle Beagle Rescue Adoption Application

Name

Home Phone

 

Address

Work Phone

 

City

State

Best time to call

 

Email

Zip

Occupation

 

Personal Reference Information (not related to you)

 

Name

Phone

 

How do you know this person?

 
 

 

       

Do you own or rent your home?

 

If rent, do you have landlord's permission to keep a dog?

 

Landlord's Name

Landlord's Phone

 

Please describe where you live (house, apartment, trailer, etc.)

 

How long have you lived at this address?

 

If less than one year, give previous address

 

Do you have a fenced yard?

Fence height and type?

 

Does fence completely enclose yard for dog?

 

If no fence, how will you handle dogs exercise and toilet duties?

 

Do you have a kennel run?

Height and size?

 
           

How many adults in household?

How many children?

 

Age of children

     

Do you own other dogs?

Are they spayed/neutered?

 

Give breed gender and age of each other dog

 

Are there regular visitors to your home, human or animal, with which your new dog must get along?

 

If yes, please describe

 

Do you own cats?

How many cats?

 

Do you own other animals? Please specify.

Do you have a regular vet?

 

Vet's Name

Vet Phone

 

Vet's Address

   
           

Which dog are you interested in adopting?

 

How many dogs have you owned in the last five years?

 

List Breed(s)

Do you still own dog(s)?

 

If not, what happened to dog(s) (please be specific)?

 

Have you lived with beagles before?

Why did you choose this breed?

 

List your plans for this dog (check all that apply)

     
Pet        
Guard        
Hunting        
Obedience        
Search & Rescue      
 

Do you want to adopt (check one)

 

   
 

Male

 

 

   
 

Female

 

 

   
 

No Preference

 

 

   
 

Age preference

Size preference

 
 

Where will dog spend the day? (check all that apply)

   
 

Loose indoors

       
 

Crate

       
 

Basement

       
 

Garage

 

 

   
 

Fenced yard

 

 

   
 

Loose outdoors

     
 

Tied up outside

 

   
 

Kennel run

 

 

   
  Other

If other, please describe

 
 

How many hours, on the average, will the dog spend alone?

 
 

Where will dog spend the night? (check all that apply)

   
 

Loose indoors

       
 

Crate

       
 

Basement

       
 

Garage

       
 

Fenced yard

       
 

Loose outdoors

     
 

Tied up outside

     
 

Kennel run

       
 

Other

If other, please describe

 
           

Do you agree to license this dog and give regular health care?

 

Do you agree to contact SBR if you can no longer keep this dog?

 

Would you be willing to let a representative of SBR visit your home?

 

If no, why?

How did you hear about SBR?

 

Additional comments?

     
 
         
     

Please read the following carefully and fill in the blanks:

All of the information I have given above is true and complete. This dog will reside in my home as a pet. I will provide adequate food, water, shelter, training, affection, and medical care. I understand that SBR is a referral service and is not responsible for the accuracy of information received about temperament, habits or physical condition of dogs available for adoption. I understand that it is my responsibility to see and evaluate the dog for myself before agreeing to adopt it. I am in full agreement with these terms of adoption. Seattle Beagle Rescue is in no way liable or responsible for any damage, accident or injury resulting from the placement of a dog into my household.


Read, understood and agreed:

(Name) (Date)