BellyRubs Basset Rescue
Foster Home Application

So that we may properly assess your capabilities, please answer the following questions as completely as possible.  Please let us know about any special needs or questions you may have.

Thank you.

Enter Your Name: (Husband & Wife, if married)
Your Street Address:
City: State: Zip:
Home Phone: Work Phone:
E-mail:
Work hours:

Do you own or rent your home?  Own  Rent

What type of dwelling is it?  House  Condo  Apartment  Mobile home

Do you have a fenced area for the dog?  Yes  No

If yes, type of area:  Kennel  Yard

Type of fencing and approximate dimensions:

If not, what arrangements will you have for the basset's exercise and toilet duties?

Have you ever owned a dog before?  Yes  No

If yes, what breed(s) have you owned? 

Have you ever owned a basset hound before?  Yes  No

Do you presently own any other animals?  Yes  No
If so, please list all animals in the home, including the sex, breed,

Are any of your animals altered? Yes  No
How long you have you owned your other animals?

How many adults are in your household? 

How many children are in your household? 

What are the ages of your children? 

How do other family members feel about fostering a basset?

Is anyone home during the day?  Yes  No

Is anyone home at night?  Yes  No

Is anyone in the home allergic to dogs?  Yes  No

Are you willing to house train a basset hound, if necessary?  Yes  No

Where will the basset hound be kept during the day? 

Where will the basset hound be kept at night? 

When you are away from home? 

Are you established with a vet (as a reference)?  Yes  No
If yes, please provide your vet's
Name: 
Address: 
City:    State:    Zip Code: 
And your vet's and phone number:

Personal references: Name, addresse, city, state, and phone #':

Sometimes we have Special Needs basset hounds that may be harder to place.
Are you willing to foster a dog with any of the following traits? [check all that apply]
senior dog [6+ years]  basset mix  basset with special medical needs

Do you agree to home visits from the BellyRubs Basset Rescue personnel, and phone calls to check on the welfare of the basset hound?  Yes  No

Please let us know about any special needs or questions you may have.

Are you over 21 years of age, able to engage in a binding legal agreement, and financially capable of providing necessary care for the basset(s) you foster? (please type Yes or No)

By clicking on the submit button, you are stating that all of the information you have provided is to the best of your knowledge, true and complete.

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