HHBR Adopt A Basset Application

ADOPTION APPLICATION Helping Hands Basset Rescue

A successful adoption depends on both the selection of the right Basset for your household and the understanding of the Basset's caretaking needs. So that we may assist you with this selection, please answer the following questions as completely as possible.
You must be 18 years old or older in order to submit an application.

All information provided is kept confidential and is used only for the purpose of HHBR operations.

If you have problems with the adoption form or it will not go through, please click here for a Printer-Friendly form. Please print out the form and mail it to:
Helping Hands Basset Rescue
PO Box 1266
Round Rock, TX 78680
or email us .

Thank you.

Please note: * marks required fields.

1.	First Name:*
2.	Last Name:*
3.	Street Address:*
4.	City:*
5.	State:
6.	ZIP Code:
7.	E-mail Address (name@host.com ):*
8.	Day Phone(xxx-xxx-xxxx):*	-
9.	Evening Phone(xxx-xxx-xxxx):*	-
10.	Best time to reach you:
11.	What type of housing do you live in?	Apt/Condo Townhouse Single Family Home
12.	Do you own or rent?	Own Rent
12a.	If you rent, does your landlord permit dogs?	Yes No Not sure
12b.	If you rent, is there a weight/size limit on allowable dogs?	Yes No
12c.	If yes, what is it?
13.	Do you have a fenced-in yard?	Yes No
13a.	If yes, briefly describe it:
14.	Makeup of household:	Adults Children
14a.	Ages of children:
15.	Anyone in household have allergies?	Yes No
16.	Which family member will be the basset's primary caregiver?
17.	How many hours per day will the basset be left alone?
18.	How close is your nearest neighbor?
19.	Will this be your first pet?	Yes No
19a.	If no, what pets have you previously had?
19b.	If no, what happened to your previous pets?
20.	What pets do you currently own?	Dog Cat Bird Other
20a.	If you currently own a dog, is is neutered/spayed?	Yes No
20b.	What breed(s) of dog do you currently own?
21.	Do you have a veterinarian?	Yes No
21a.	If yes, what is the Vet's name and phone number, including area code?
21b.	What pet name and last name are your current vet records under?
21c.	If you have recently moved and don't have a vet in your new area OR if your dog has passed away, please provide your past vet's contact information.
22.	Why do you want to adopt a Basset Hound? Which of our available bassets are you interested in?
23.	Would you prefer a male or female Basset?	Male Female No Preference
24.	What age Basset do you prefer?
25.	Where will your Basset spend most of its time?
26.	Are you willing to crate train your Basset?	Yes No
27.	Do you agree to return your Basset to HHBR if you are unable to keep it?	Yes No
28.	Are you willing to provide us with follow up reports?	Yes No
29.	How were you referred to HHBR?
30.	Are you interested in learning about our foster care program?	Yes No
ALL OF THE INFORMATION I HAVE PROVIDED ON THIS APPLICATION IS, TO THE BEST OF MY KNOWLEDGE, TRUE AND COMPLETE. I UNDERSTAND FALSIFYING ANSWERS ON THIS APPLICATION, OR AT ANY OTHER TIME DURING THE ADOPTION PROCESS, DISQUALIFIES ME FROM ADOPTION. ONCE SUBMITTED, THIS APPLICATION WILL BE SENT TO THE APPROPRIATE CONTACT. YOU WILL RECEIVE A RESPONSE ACKNOWLEDGING THIS APPLICATION WITHIN 48 HOURS. The Helping Hands Basset Rescue adoption fee of $175 covers necessary care of the hound prior to its adoption. This fee is due upon adoption. Please click the submit button only once. The form may take a few minutes to process. If you don't receive confirmation within 72 hours, please resubmit the application.