Name:	Date:
Address:
City:	State:   Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Ontario Prince Edward Island Quebec Saskatchewan Yukon   Zip:
Day Phone: (xxx-xxx-xxxx)	Evening Phone: (xxx-xxx-xxxx)
Email:
How did you hear about Hound Rescue:

Do you live in a:     House   Apartment   Duplex   Townhouse/condo   Mobile

Do you own or rent:     Own   Rent    Name and phone of landlord:

I authorize the landlord, if any, and their agents to release to Hound Rescue any information in my rental agreement that pertains to pet owning and keeping.

I accept the above terms:     Yes   No

Number of adults in household:    Number of children:    Ages:

Is anyone in your family allergic to dogs:     Yes   No  How will they accommodate:

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What pets are currently in your household?
TYPE	NAME	SPAYED NEUTERED?	KEPT WHERE?	BREED/SEX	AGE	YEARS HAD?
DogCat		YesNo	InOut	FemaleMale
DogCat		YesNo	InOut	FemaleMale
DogCat		YesNo	InOut	FemaleMale
DogCat		YesNo	InOut	FemaleMale
List your previous pets and describe why you no longer have them.
TYPE	NAME	SPAYED NEUTERED?	KEPT WHERE?	BREED/SEX	AGE	YEARS HAD?
DogCat		YesNo	InOut	FemaleMale
Explanation:
DogCat		YesNo	InOut	FemaleMale
Explanation:
DogCat		YesNo	InOut	FemaleMale
Explanation:
DogCat		YesNo	InOut	FemaleMale
Explanation:

Name and phone of veterinarian:

Name of record holder:

I authorize the veterarinarian listed above and their agents to release to Hound Rescue any information pertinent to evaluating my history of pet ownership, if any.

I accept the above terms:     Yes   No

Are you interested in a specific beagle(s) available for adoption, and if so, which one(s)?

If this dog is no longer available, would you consider adopting a different dog through Hound Rescue:     Yes   No

Why do you want to adopt this particular pet/breed:

What specific traits are you looking for in a dog (i.e. crate trained, good with other dogs/cats, etc.):

To provide food, medical care, registration and grooming for this pet how much do you anticipate spending yearly:    $100   $200   $300   $400   $500   $600 or more

Are you familiar with your local city regulations requiring pets to be licensed every year:     Yes   No

How will you exercise and interact with your pet:

How may hours per day will this pet spend alone:    Why:

Where will you keep your pet at night:

Where will you keep your pet when you are at work:

How will you confine your pet outdoors (check all that apply):     Fence, type and height    Kennel Run   Patio   Garage   Leash   Chain/Tie out/Runner   Other

Where will you keep your pet when you travel away from home:

What will you do if your pet is destructive (digs, chews, etc.):

Do you know you may have to discipline and/or housetrain your pet, which may require time and patience. Are you willing to commit to any necessary training:     Yes   No

Do you plan to have your pet spayed or neutered:     Yes   No

How will you prevent your dog from getting heartworms:

If you suddenly relocated or had other drastic lifestyle changes that made it hard to keep your pet, what would you do with him/her:

If the pet becomes seriously ill or injured and your veterinarian says expensive medical treatment is needed, what will you do:

Would you object to a follow-up call/visit from Hound Rescue:     Yes   No

I accept the above terms:     Yes   No